Racial Equity in Renal Transplantation: The Disparate Impact of HLA-Based Allocation
Gaston, Robert S.
Dooley, Laura G.
Diethelm, Arnold G.
JAMA. 1993 Sep 15; 270(11): 1352-1356.
Conclusion: The equitable and efficient distribution of limited resources, such as cadaveric kidneys, requires careful evaluation of all the effects of allocative choices that are made. In this essay, we have focused, perhaps simplistically, on the racial impact of allocation policies: clearly, race is not the sole issue impacting organ allocation. However, HLA-based allocation is equally simplistic in the assumption that universal benefit will result from better matching. The truth is that some will benefit, and others will not. Disproportionate representation of African Americans in the ESRD population dictates that racial considerations cannot be ignored in the distribution of cadaveric kidneys in the United States. Efforts to increase black donation are to be encouraged but will not eliminate disparity. If racial equity in renal transplantation is to be achieved, alternative allocation strategies must be formulated that forthrightly address the interests of all potential recipients.
African Americans; Cadavers; Donors; Evaluation; Justice; Kidney Diseases; Kidneys; Organ Donors; Organ Transplantation; Prevalence; Public Policy; Resource Allocation; Renal Transplantation; Scarcity; Selection for Treatment; Statistics; Tissue Transplantation; Transplant Recipients; Transplantation;
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