New requirement uses race-neutral formula to determine eligibility, accessibility for a kidney transplant

(ABC 6 News) – A new requirement in transplant centers will help many at-risk patients of color, get on the kidney transplant list sooner.

The new requirement, which was recently approved by the Organ Procurement & Transplantation Network’s board, centers on how a patient’s glomerular filtration rate, or GFR, is calculated. This rate estimates how much blood the kidneys’ filtering units clean every minute based on a person’s body size.

Some transplant centers, including Mayo Clinic, directly measure the glomerular filtration rate to determine a patient’s kidney function. But direct measurement of kidney function is not widely available across laboratories and is cost-prohibitive for routine clinic use. Therefore, many health care professionals rely on calculated estimates of the glomerular filtration rate known as eGFR. This estimate is important because it determines whether a patient qualifies to be put on the transplant waiting list.

Some formulas commonly used to estimate kidney functions include a Black race variable. Those formulas report higher eGFRs for Black people, compared to non-Black people with similar characteristics. Recent research has found that these race-based calculations can end up overestimating a Black patient’s kidney function by as much as 16%.

This comes after changes to a formula that was found to have a "black race variable", which would overestimate their remaining kidney function consequently underestimating their medical urgency.

She believes the change is a giant step in the right direction. But says there’s still serious work to be done to establish more trust between minorities and health care providers.

"There is a distrust that exists because in most cases the providers don’t look like us. So, we don’t have the opportunity to develop and floss through those relationships. We have to assure that our provider networks are much more diverse than they currently are. And as some of these providers are aging out, what needs to replace them is providers that look like the communities that they serve, because then the issues rise to the top and become more of a priority," said Angel Uddin, Director of Equity, Diversity, and inclusion at the University of Minnesota.

Experts are optimistic this transplant policy change will encourage more people, especially people of color, to consider becoming organ donors.

Uddin says there are several programs across the country working to address the lack of diversity.

In Rochester, the Mayo Clinic launched the pathways program to help recruit people from diverse backgrounds to get into health care.