Racial Disparities
Summary: Communities of color are particularly disadvantaged by failures in the organ donation system, making current bipartisan reform efforts all the more urgent, especially given added risks to patients from COVID-19.
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Black Americans are 3 times more likely to develop kidney failure than white Americans, yet are still far less likely to be referred for a transplant than whites.
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Of the 110,000+ Americans on the waiting list for transplants, 65,000 are minorities.
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48% of White Americans on the waiting list received a transplant in 2019, yet the same number was only 26% for Black Americans.
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Outsized need for organ transplants in minority communities
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​OPOs - contractors tasked with coordinating organ recovery - fail to recover 28,000 organs every year.
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In 2019, HHS published a notice of proposed rulemaking finding the majority of OPOs failing baseline standards. (See areas in red.)
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Donors and recipients of the same ethnicity are more likely to match, so OPOs’ failure to recover organs from Black donors hurts Black recipients.
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Failures of Organ Procurement Organizations (OPOs)
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​Research finds donation rates result from differential treatment. The most common reasons Black families decline to donate are OPOs did not “give [them] enough time to discuss important issues... or respond to strong emotion with sensitivity and empathy."
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Research finds donation rates “are higher for AAs when the OPO staff discussing donation are also AA, but the majority of OPO staff continue to be Caucasian.”
Congressional support for reform
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The Senate Finance Committee and Rep. Katie Porter have initiated oversight into OPOs, with the public support of Rep. Karen Bass.​
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To support patients, oversight committees (Ways & Means and Energy & Commerce) and Congressional offices can:
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Some OPOs are calling for race-based performance adjustment, prompting Ben Jealous, former NAACP CEO, to write: “Consider the Los Angeles OPO. It recovers just three out of ten potential donors, and ... its formal response to HHS... is deeply concerning: Its poor performance is not its fault because it serves a “population that is substantially non-white”... the real problem is that too often [OPOs] do not engage with our communities.”
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​Urge HHS to finalize the NPRM, condemning race-based and urging HHS to implement the new standards in the upcoming 2022 recertification cycle; and
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​Support ongoing Congressional oversight into OPOs, initiating new oversight into the root causes of racial disparity in the organ donation system. ​