Racial disparities in kidney transplant and living donation

In the US, racial–ethnic minorities experience disproportionately high rates of end-stage renal disease (ESRD) but are far less likely than their majority counterparts to receive kidney transplants, the optimal therapy for many patients with ESRD. Despite long-standing recognition of the need to reduce racial–ethnic disparities in transplantation, relatively little progress in identifying effective mechanisms to narrow disparities has been made. In this chapter, we describe the nature of disparities in the need for and access to kidney transplantation. We also describe barriers that contribute to disparate rates of transplantation among racial–ethnic minorities in the US. We conclude with a discussion of promising interventions to eliminate racial–ethnic disparities in transplantation and the potential roles living kidney donation and living donor advocacy could play in helping to eliminate disparities.