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Black Americans and Organ Transplant Waiting Lists
Transplant waiting list criteria may seem somewhat straightforward, but that is far from the case for many Black Americans. Research published in Kidney International determined that the median number of days on a kidney waiting list was 87 percent higher for a Black person than for a white person.
A study published in September 2021 in Hepatology found that Black patients have less access to liver transplant waiting lists. Findings from this study also suggest that Black patients most likely are not referred for a transplant at the same rate as other patients. Similarly, a study published in 2021 in the Journal of the American College of Surgeons found that of over 34,000 liver transplants, only around 9 percent of recipients were Black.
According to Hool, the disparities don’t stop there. He says that not only are Black people not being placed on waiting lists by their providers, but they also have less access to insurance, and there is even a lack of awareness in the Black community that liver transplant surgery is an option for them. Hool adds that living far from a transplant center can contribute to the disparities.
“It is the medical provider’s responsibility to ensure that all patients are well educated on all available treatment options. This, sadly, has not been the case,” Hool adds.
Black Americans and Posttransplant Success
Research has found that Black people with liver cancer who do receive a transplant have a lower chance of surviving after the transplant compared with other racial and ethnic groups.
“We see more Black patients with larger tumors due to delayed diagnosis and treatment, because of lack of access to health insurance and racial bias among healthcare providers,” Hool explains.
Research bears this out. A study published in Digestive Diseases and Sciences found that Black patients usually had larger tumors at the time of diagnosis and treatment, indicating that diagnosis occurred at later stages of the disease.
Despite increased awareness of the racial disparities that affect Black people seeking liver transplants, Hool feels there’s a long way to go and remains concerned for Black Americans diagnosed with liver cancer.
“The fact is, these disparities still very much exist, but that does not have to be the case,” Hool says. More research and clinical trials need to be done, he says, and medical providers need to be better trained about bias and best practices for working with racially and ethnically diverse patients. “We have only scratched the surface to better understand why these disparities exist, let alone actively doing something about them.”
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