June 15, 2023
LaQuayia "LQ" Goldring stood in her living room, holding the letter her mom had just handed her. The organ transplant team had good news: She might move up on the waitlist for a kidney transplant. A key formula used to determine her place in the waitlist was racially biased and would be redone.
But it felt like "a slap in the face," Goldring, 33, says. Years had been wasted.
Goldring has had kidney disease almost all her life. She lost her left kidney to a rare cancer as a toddler. Her right kidney started to fail when she was a young teen. She got it replaced, but with kidney disease in her genes, the transplanted kidney soon began to fail. At 25, Goldring rejoined the kidney waitlist.
Like Goldring, more than 103,000 people in the U.S. are registered on organ transplant waitlists. Exactly how long they'll wait can vary from days to years, depending on things including how sick they are, organ availability, and how well the patient matches with a donor.
The demand for donated organs far exceeds the supply. Compared to White patients on the list, Black patients are less likely to get an available organ. In 2021, 47% of White patients on the waiting list received transplants, compared to nearly 28% of Black people on the waiting list, according to the Office of Minority Health (part of the U.S. Department of Health and Human Services).
The waitlists rely on a complex mix of factors. Race, by itself, is not one of those factors. "But people of color face greater barriers from the moment their organ fails, to getting on the waiting list, to actually receiving a transplant -- if they ever do," says Charles Bearden, the longest-serving organ recovery/transplant coordinator in the U.S. He contributed to a 2022 National Academies of Sciences, Engineering, and Medicine report on inequities in the organ transplant system. That report states, "The current organ transplantation system in the United States is demonstrably inequitable. Certain groups of patients (e.g., racial and ethnic minority populations, lower socioeconomic status, female gender, older patients, individuals with intellectual and developmental disabilities, or inheritable diseases such as cystic fibrosis) receive organ transplants at a disproportionately lower rate and in some cases after longer wait times than other patients with comparable need."
For example, Black people on the kidney transplant list wait, on average, a year longer than White patients to get a kidney transplant, according to the National Kidney Foundation.