NCPA - National Center for Policy Analysis

Timelier Transplants

February 19, 2004

New rules for allocating scarce kidneys will result in 6.4 percent more blacks getting transplants, while slightly increasing the number of unsuccessful transplants, a study finds.

Blacks and other minorities have long been disadvantaged on transplant waiting lists -- in part because the scoring system gave strong priority to compatibility between a recipient and the donated organ. Although blacks donate organs as often as whites, they have an extremely wide variety of protein markers on the outside of their cells -- making an exact match much harder to find than for whites.

The new rules, implemented in May by the United Network for Organ Sharing, stop giving priority for a certain type of immunological match known as HLA-B. Researchers used a statistical method to predict what would happen under the new rules.

They found:

  • Had the new rule been in effect in the year 2000, 2,292 blacks would have gotten kidneys, up 6.4 percent from the actual number of 2,154 blacks.
  • Meanwhile, 3,954 whites would have gotten the organs, a decrease of 4 percent.
  • Hispanics would have seen a 4.2 percent increase and Asians would have seen a 5.9 percent increase.
  • In addition, in the first four months of the new rules, 39 percent of available kidneys went to blacks, Hispanics, Asians and other minorities -- an increase of 7 percent over the same period in 2002.

The study indicates that the new rules will lead to about 2 percent more organs being rejected in all races. However, researchers say that is a fair tradeoff. Improved organ transplant methods, including better transplant-rejection drugs, have made strict matching far less necessary than it was in 1988 when the original rules were implemented.

Sources: Laura Johannes, "New Kidney-Transplant Rules Benefit Blacks, Other Minorities," Wall Street Journal, February 5, 2004; based upon John Roberts, et al, "Effect of Changing the Priority for HLA Matching on the Rates and Outcomes of Kidney Transplantation in Minority Groups," New England Journal of Medicine, February 5, 2004.

For WSJ text,,SB107593850423521112,00.html


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