Revision to Organ Donor Match Criteria Allows More African Americans To Receive Kidneys, Study Finds
A revision to donor-recipient matching criteria that the United Network for Organ Sharing implemented in May will lead to an estimated 6.4% more African-American patients receiving kidney transplants and will slightly increase the rate of unsuccessful transplants, according to a study in the New England Journal of Medicine, the Wall Street Journal reports. According to the Wall Street Journal, under old UNOS rules it was "much harder to find" an exact match for African Americans because although they donate organs at the same rates as whites, they have an "extremely wide variety" of protein markers that are used to genetically match donated organs to recipients. Under the new rules, UNOS has stopped giving priority for a certain type of genetic match called HLA-B. To inform the decision about the rule change, UNOS enlisted researchers led by Dr. John Roberts, a surgeon at the University of California-San Francisco, to determine possible effects; the results of that study were presented privately to UNOS' kidney committee last year and published in this week's NEJM. The researchers used statistical methods to predict what the effects of the criteria change would have been had it been implemented in 2000. They found that the number of African-American patients who would have received kidneys would have increased 6.4% to 2,292 from the actual number of 2,154. The number of white recipients would have decreased by 4% to 3,954, while the number of Asian recipients would have increased by 5.9% and the number of Hispanic recipients would have increased by 4.2%. The study also found that under the criteria change, organ rejections would have increased by about 2% among all racial groups, the Wall Street Journal reports (Johannes, Wall Street Journal, 2/5).
In the first four months following the actual criteria change, 7% more African-American patients received kidneys, consistent with the study's findings, according to Dr. Friedrich Port, president of the Michigan-based University Renal Research and Education Association (Nano, AP/Contra Costa Times, 2/5). Roberts said that the "benefits" of the rule change "outweigh the costs," adding that improved organ transplant methods, including better transplant-rejection drugs, have made strict matching far less necessary than in 1988 when the original rules were implemented (Wall Street Journal, 2/5). In an accompanying editorial, Dr. Jon van Rood of the Netherlands-based Eurodonor Foundation writes, "Patients who have received a transplant should be included in lifelong follow up studies if we want to learn about the long-term effects" of the new matching criteria (van Rood, New England Journal of Medicine, 2/5). An abstract of the study is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.