Transplant surgeons at the University of Maryland Medical Center say they have successfully reduced barriers to kidney transplantation for African-Americans to cut the median waiting time for transplant in half. Their achievement stems from a comprehensive program that includes patient education and efforts to increase living donation and improve overall kidney graft survival. Results of their decade-long strategy are being presented today (April 25) at the American Surgical Association national meeting in Hot Springs, Virginia.
Lead author of the report, Clarence E. Foster, III, M.D., a transplant surgeon at the University of Maryland Medical Center, says African-American patients now have a median waiting time of 681 days to receive a transplant at the medical center. Nationally, according to the United Network for Organ Sharing (UNOS) database, African-Americans wait about 1,335 days.
African-Americans encounter several barriers to kidney transplantation. Doctors traditionally have been less likely to suggest transplantation to their African-American patients because of lower rates of kidney survival and a higher rate of acute organ rejection, says Dr. Foster, who is also an assistant professor of surgery at the University of Maryland School of Medicine.
As a result, African-Americans are less likely to be referred for transplant, they are placed on transplant lists less often after evaluation and end up waiting much longer because fewer organs are available that are a good match, adds Dr. Foster.
The University of Maryland Medical Center has the largest kidney transplant program in the United States. During the past ten years, over 2,100 kidney transplants have been performed. Forty-three percent of the Maryland transplants were in African-Americans, significantly more than the UNOS-computed national average of 32 percent.