Colleen L. Jay, M.D., M.S.C.I., assistant professor and the Valero President’s Distinguished Chair in Transplantation at UT Health San Antonio, and Francisco G. Cigarroa, M.D., professor and the Carlos and Malú Alvarez Distinguished University Chair in Pediatric Transplant Surgery at UT Health, published an invited editorial Jan. 2 in the Journal of the American Medical Association (JAMA). The title is “Disparities in Live Donor Kidney Transplantation: Related to Poverty, Race or Ethnicity?”
Dr. Jay and Dr. Cigarroa are surgeons in the University Transplant Center, a clinical partnership of UT Health San Antonio and University Health System. Their editorial is in response to a study, published Jan. 2 in JAMA, that found the proportional incidence of live donor kidney transplantation among black and Hispanic patients was lower in 2010-2014 than it was in 1995-1999.
Absolute numbers of live donor kidney transplants in black and Hispanic patients increased by 2010-2014, the study showed. In the editorial, Dr. Jay and Dr. Cigarroa put this into perspective, noting that, “Despite improvements in disparities related to access to the waiting list and deceased donor kidney transplantation rates, large disparities in live donor kidney transplantation rates remain.”
The editorial notes these contextual factors:
— Inequalities persist with delays in referral and access to the kidney transplant waiting list.
— Differences in socioeconomic factors continue to be pervasive for many black and Hispanic patients in the U.S.
— Among Hispanic patients, health insurance coverage explained the greatest proportion of disparity.
— Higher rates of obesity, diabetes, hypertension and metabolic syndrome affect the medical suitability of potential donors.
— Potential kidney donors face financial disincentives. Time lost to work and out-of-pocket costs are two possible reasons.
“Efforts to improve financial neutrality for living donors may in fact also contribute greatly to mitigating disparities still existing according to race/ethnicity,” Dr. Jay and Dr. Cigarroa wrote.