According to a new study from scholars at the Massachusetts Institute of Technology and Massachusetts General Hospital, Black patients in need of an organ transplant are less likely than White patients to have their organ offer accepted by their physician.
When a patient is matched with a viable organ for transplant, the patient’s physician decides on their behalf whether to accept or reject the offered organ. Using data on more than 160,000 transplant candidates in the Scientific Registry of Transplant Recipients between 2010 and 2020, the study authors found physicians are less likely to accept liver and lung offers for Black patients. Compared to White patients with similar wait-list priority, Black patients were 7 percent less likely to have a liver offer accepted, and 20 percent less likely to have a lung offer accepted. Patients whose organ offers were rejected were associated with significantly lower survival times.
Notably, the authors found that a donor-candidate race match was associated with significantly higher odds of acceptance for heart and liver transplants. However, this finding could place Black patients at a disadvantage, as there are fewer Black organ donors than their are Black candidates. For example, in this study, Black patients made up 24 percent of wait-listed candidates, but only 17 percent of donors for heart transplants.
“In conclusion, our study demonstrates the additional barriers Black patients face in transplant access due to transplant center decision-making,” the authors write. “Prior work has ignored this step as a potential source of inequity in organ allocation.”
They continue, “We advocate for greater transparency and standardization in acceptance decisions, well-designed continuous distribution policies, and a strong policy focus on equitable organ procurement.”
