Organ network to remove race, hepatitis C coefficients for evaluating organ function
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Key takeaways:
- Procurement specialists will no longer use race or hepatitis C to determine organ health.
- The current formula suggests that donor kidneys from African American or Black patients function for a shorter period.
The Organ Procurement and Transplantation Network has removed two variables – whether a potential organ donor is African American or Black or has tested positive for the hepatitis C virus – from methods to evaluate deceased donor organs.
“The entire donation and transplant community is committed to increasing equity, and this policy change takes an important step toward reaching that goal,” Dianne LaPointe Rudow, DNP, Organ Procurement and Transplantation Network (OPTN) board president, said in a press release. “Kidney transplant clinicians often rely on the [kidney donor profile index] KDPI to inform their decision of whether to accept a kidney offer for their patient.
“By removing race as a factor, we expect more kidneys from Black organ donors will be accepted, particularly for Black recipients, who may be a close match based on immune system matching.”
The KDPI is a calculation that estimates the likely length of function of kidneys from a deceased donor based on several criteria determined by the OPTN.
“The existing KDPI formula suggests that kidneys from donors identified as African American or Black are likely to function for a shorter amount of time than those from donors with other racial or ethnic backgrounds,” according to a release from the OPTN. “Also, when the KDPI was established in deceased donor kidney allocation policy in 2014, hepatitis C was generally considered an incurable virus, and kidneys from HCV-positive donors were expected to last less time than kidneys from HCV-negative donors.
“The later introduction of highly successful medications to treat HCV has greatly reduced the negative effect, even if a kidney from an HCV-positive donor is transplanted into an HCV-negative recipient,” the OPTN board noted in the release.
Deidra C. Crews, MD, ScM, FASN, American Society of Nephrology president, said in a press release that the revised formula “will better reflect the likelihood of graft failure for kidneys from deceased donors, and appropriately reflects the fact that race is a social, and not a biological, construct.”
Sylvia E. Rosas, MD, MSCE, president of the National Kidney Foundation, added: “We believe all patients deserve equal access to kidney care and will continue to work toward that goal. Removal of the African American/Black race coefficient from the score used to evaluate the suitability of the kidney for transplantation is likely to improve transplant equity.”
“This [race coefficient] has been a dishonor to African American/Black donors and a disservice to patients waiting for a life-saving kidney transplant,” Kevin Longino, CEO of the NKF and a kidney donation recipient, said in the release. “We applaud OPTN for advancing this change and are optimistic that this policy will promote equity and increase the number of kidneys available for transplant now.”
Reference:
New policy will remove race, improve equity in transplantation. https://www.kidney.org/news/new-policy-will-remove-race-improve-equity-transplantation. Published July 8, 2024. Accessed July 9, 2024.
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