Kids' Kidney Transplant Rules May Have Shrunk 'Race Gap'

Before 'Share 35,' black and Hispanic patients were less likely to receive organ than whites, researchers say

By Robert Preidt

Thursday, April 26, 2012

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THURSDAY, April 26 (HealthDay News) -- Racial disparities in kidney transplants for U.S. children have fallen since a new policy was introduced in 2005 by the United Network for Organ Sharing, researchers say.

The policy, called Share 35, preferentially offers kidneys from deceased donors younger than age 35 to children who need a kidney transplant. While a kidney from a living donor is preferable, a kidney from a deceased donor can save a child's life.

In the past, black and Hispanic children with kidney failure were less likely to receive a kidney transplant than white children, the study authors noted.

In the new study, Dr. Sandra Amaral of The Children's Hospital of Philadelphia and colleagues looked at nearly 2,300 children with kidney failure who received a transplant before Share 35 and more than 2,400 who received a transplant after the introduction of the new policy.

Overall, children with kidney failure were 46 percent more likely to receive a deceased-donor kidney transplant after Share 35 was implemented, with increases of 81 percent for Hispanics, 45 percent for blacks, and 37 percent for whites.

After Share 35 took effect, deceased-donor transplants occurred an average of 201 days earlier for Hispanic patients, 90 days earlier for black patients, and 63 days earlier for white patients.

With Share 35, children of all races had a shift from living- to deceased-donor kidneys. The reduction in living-donor kidneys was 48 percent for Hispanics, 46 percent for blacks and 25 percent for whites.

The findings show that Share 35 has reduced racial disparities in terms of how likely and how soon children will receive a deceased-donor kidney transplant, Amaral and colleagues noted.

The study was published online April 26 in the Journal of the American Society of Nephrology.

"Reduced racial disparities in access to deceased-donor kidney transplant for children with end-stage kidney disease is a very positive step toward achieving equity in overall transplant access for all children; however, greater declines in living donors for all pediatric patients, particularly for those of black or Hispanic ethnicity, may be a concern," Amaral said in a journal news release.

"Less access to living donors for children with end-stage kidney disease may mean that these patients have less access to the best-quality kidneys and less potential for the best graft survival," she explained.

Currently, more than 800 children and adolescents in the United States are waiting for a kidney transplant.

SOURCE: American Society of Nephrology, news release, April 26, 2012

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