OPTN Board Approves Removing Race-Based Calculations of Kidney Function for Transplant Patients A diverse workgroup of patients, physicians developed the equity-focused proposal
The Board of Directors of the Organ Procurement and Transplantation Network (OPTN) yesterday approved a measure that will require transplant hospitals to no longer consider race when estimating a patient’s kidney function. The action, which will take effect July 27, will ensure that all candidates are assessed more equitably. United Network for Organ Sharing (UNOS), the engine that powers the donation and transplant system, serves as the OPTN under federal contract.
“This is an important step forward, in keeping with broad efforts to provide equitable healthcare for all,” said Matthew Cooper, M.D., president of the board. “Communities of color are disproportionately affected by end-stage kidney disease, so we must do all we can within our power to ensure that they receive the utmost access to lifesaving care.”
The action will require all transplant hospitals to use race-neutral calculations when estimating a transplant candidate’s kidney function.
For years, some calculations (known as eGFR) have included a modifier for Black patients based on outdated assumptions about race and biology. This practice has led to the severity of kidney disease in Black patients being systemically underestimated. It may have also negatively affected when Black patients get added to the national waitlist.
The board is also developing a policy to address patients previously impacted by this measure. This new policy, which will soon come up for public comment, will correct the waiting time for Black patients who may have been affected by the race-based calculation.
The OPTN Minority Affairs and Kidney Transplantation Committees co-sponsored the proposal that was approved by the board. The removal of race variables from eGFR calculations has been broadly supported by institutions, including the National Academies of Sciences, Engineering and Medicine, as well as a joint task force of the American Society of Nephrology (ASN) and the National Kidney Foundation (NKF). Improving equity in access to transplant opportunities for patients is an OPTN strategic goal.
About UNOS
United Network for Organ Sharing (UNOS) is a non-profit, charitable organization that serves as the Organ Procurement and Transplantation Network (OPTN) under contract with the federal government. The OPTN helps create and define organ allocation and distribution policies that make the best use of donated organs. This process involves continuously evaluating new advances and discoveries so policies can be adapted to best serve patients waiting for transplants. All transplant programs and organ procurement organizations throughout the country are OPTN members and are obligated to follow the policies the OPTN creates for allocating organs.
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