MINIMIZING RACIAL DISPARITY REGARDING RECEIPT OF A CADAVER KIDNEY-TRANSPLANT

This report describes the impact of race on waiting list entry and rec eipt of a cadaver kidney transplant, after accounting for self-reporte d income, health and functional status, and patients' attitudes about dialysis and transplantation as treatment alternatives, Previous studi es did not account for these race-related factors and therefore produc ed biased estimates of the impact of race on waiting list entry and re ceipt of a transplant, Data for this investigation came from a telepho ne survey of a national sample of 456 end-stage renal disease patients and from files maintained by the United Network for Organ Sharing and the Health Care Financing Administration, Proportional hazard models were estimated with these data, The results indicated that approximate ly 60% of the differences between black and white waiting list entry r ates and 52% of the black-white differences in transplantation rates w ere due to race-related differences in socioeconomic status, health an d functional status, severity of illness, biological factors, the exis tence of contraindications to transplantation, transplant center chara cteristics, and patients' attitudes about dialysis and transplantation . Potential ways to narrow racial differences further include better e ducation about treatment alternatives for black patients, more vigorou s efforts to obtain donor organs from minorities, continued research a nd thoughtful policy on the access-related impacts of United Network f or Organ Sharing point system variances, and consolidation of some sma ller waiting lists into larger regional lists. (C) 1997 by the Nationa l Kidney Foundation, Inc.