2014 Policy Change Shows Small Improvement in Racial and Ethnic Disparities for Children Waitlisted on Transplant List

In December 2014, a U.S. policy change was implemented to help improve equity in access to transplantation. A new study, led by Jill Krissberg, MD, MS, in CJASN has assessed the impact of this policy, called the Kidney Allocation System.

Dr. Krissberg, and her colleagues studied children on the U.S. kidney transplant list from 2008 to 2019. The investigation found no racial and ethnic disparities regarding time on the waitlist until transplantation either before or after the 2014 policy change. However, racial and ethnic disparities for time spent on dialysis prior to transplant improved in equity after 2014 which was when the policy change occurred.

The place that this policy change seemed to have the most effect was it helped make time on dialysis to transplantation equitable across racial and ethnic groups after adjusting for other factors that can impact how kidney transplants are allocated. There are other important elements affecting access to transplant for children of color that still need to be explored. “This work is just the beginning”, said Dr. Krissberg. “We also identified that all children, regardless of race or ethnicity, waited longer for kidney transplants after this 2014 kidney allocation system change. This policy change may have unintended consequences for vulnerable children and should be considered in future transplant legislation,” Dr. Krissberg added.