A new initiative to increase the number of black Americans registered as organ donors and address disparities among transplant recipients was announced Thursday by a coalition that includes the country’s four historically black college and university medical schools. .
The collaboration follows a report by the National Academies of Sciences, Engineering, and Medicine, “Realizing the Promise of Equity in the Organ Transplant System,” which revealed significant disparities in the transplant system. organs of the country. It was released earlier this year and commissioned by Congress, which wanted to examine fairness within the system of procurement, allocation and distribution of donor organs.
The initiative – which was created by the HBCU Consortium of Medical Schools, the organ donation advocacy group and the Association of Organ Procurement Organizations – plans to create new opportunities for black medical students and nursing to track organ procurement organizations and transplant centers and collaborate with HBCU partners. that offer programs in nursing, public health, public policy and health care administration. The announcement of the initiative was first shared with The Associated Press.
The HBCU consortium behind the initiative includes Charles R. Drew University of Medicine and Science in Los Angeles, Howard University College of Medicine in Washington, Meharry Medical College in Nashville, Tennessee, and the Morehouse School of Medicine in Atlanta.
As part of the initiative, healthcare professionals will speak to K-12 students in Black communities about the field and career paths. It will also focus on community education, including creating accessible transplant materials for dialysis patients and hosting health fairs and blood drives.
Concerns about equitable access to organ transplants have existed for decades in America. But attention has grown in recent years after the global COVID-19 pandemic wreaked disparate havoc among black Americans and laid bare the country’s longstanding racial inequalities caused by structural racism, inequality access to care and prejudices within the country’s medical system.
“At the heart of it all is the profound disparity in transplants that are donated and performed on African Americans versus whites in our country, and that’s a problem and a long-standing problem,” said the Dr. James EK Hildreth, President and CEO of Meharry. Medical College, in an interview with The Associated Press.
“And some of that messaging has to come from trusted organizations, which is another reason why we believe the four black medical schools have a very important role to play that honestly could not be fulfilled by any one other organization in the country. said Hildreth.
HBCU medical schools have historically served as a necessary pipeline for black physicians and other medical professionals. Hildreth said the initiative will increase those numbers. The HBCU Medical School Collaborative was formed in 2020 to address health equity amid the pandemic. But Hildreth said the schools used to work together, often in areas of disparity that the medical and health systems have historically ignored.
But the HBCU collaboration has since grown, and they’ve identified kidney transplants and donation as an area of concern because black nephrologists — doctors who diagnose and treat acute and chronic kidney problems — make up less than 7% of the population. industry and only 5.5% of transplants. the surgeons are black.
About 80% of Meharry graduates go on to work in underserved communities, Hildreth said, and 85% are black. The vast majority of them come from households with lower incomes than a typical white medical student.
“Minorities and people of color have historically been underrepresented in medicine, and the field of organ and tissue donation and transplantation is no exception,” said Dr. Clive Callender, transplant surgeon and professor of Medicine at Howard University College of Medicine, which is seen as a pioneer in organ donation equity. “This collaboration will allow us to save thousands of lives across the country by strengthening relationships between healthcare workers, black and minority patients, and organ and transplant professionals.
According to the Department of Health and Human Services’ Office of Minority Health, black Americans are the largest group of people of color in the United States who need organ transplants. According to the National Institute of Diabetes and Digestive and Kidney Diseases, black Americans are almost four times more likely than white Americans to develop kidney failure.
And while black Americans make up about 13% of the US population, they make up 35% of people with kidney failure, which accounts for the majority of transplants. The National Academies of Sciences, Engineering, and Medicine — or NASEM — report set a benchmark for increasing organ transplants to 50,000 per year by 2026; 41,354 transplants were performed in 2021, an increase of 5.9% compared to 2020.
However, while 28.5% of total applicants currently awaiting transplants are Black Americans, they accounted for only 12.9% of organ donors in 2020. The total number of white Americans on organ lists waiting for organ transplants is about 1.4 times that of blacks, but the number of candidates waiting for kidney transplants is almost the same between the two groups.
“The moment they get on the list, there is great urgency. And because of the long waits, a lot of them, of course, fail to get a transplant,” Hildreth said of black applicants.
Annual transplant records were set last year in three main areas, including 24,669 kidney transplants, 9,236 liver transplants and 3,817 heart transplants. And of 57 organ procurement organizations nationwide, 49 saw increases from 2020 and 45 set all-time records for donors recovered in a single year.
But the disparities still exist.
Jill Grandas, executive director of DCI Donor Services, an organ procurement organization that serves Tennessee, New Mexico and California, said DCI will work with HBCUs on the ground in communities and across sectors of the health to raise awareness about transplants and become organ donors. She said her team is encountering levels of mistrust among Black Americans and other people of color that are rooted in a historic lack of trust in a health care system that has hurt their families and communities.
The lack of industry leaders working to break down “trust barriers” through education and direct programming is another factor, Grandas said. There must also be a lens of accountability placed on organ procurement and transplant centers to ensure they are working to address disparities, Grandas added.
“Fairness is an issue that needs to be addressed,” Grandas said.
Renée Landers, a former HHS deputy general counsel who was on the NASEM report’s editorial board, said she hopes the initiative will spur more action to address transplant and donor disparities, but also in the domain of health.
“Having this particular focus on training or encouraging people of color to enter health professions as doctors and other types of caregivers is really important,” said Landers, a law professor and director of the health and biomedical law school at Suffolk University School of Law in Boston. “And black medical schools can play a very important role in that.”
Stafford is based in Detroit. She is the national investigative racing editor for the AP’s Race and Ethnicity team. Follow her on Twitter at https://twitter.com/kat_stafford.
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