<div class="" data-article-body="true"><p class="mb-4 text-lg md:leading-8 break-words">As one of the <a href="https://www.cdc.gov/nchs/fastats/kidney-disease.htm" rel="nofollow noopener" target="_blank" data-ylk="slk:leading causes of death;elm:context_link;itc:0;sec:content-canvas" class="link ">leading causes of death</a> in the U.S., kidney disease is a serious public health problem. The disease is particularly severe among Black Americans, who are <a href="https://www.kidney.org/content/black-health-ny#" rel="nofollow noopener" target="_blank" data-ylk="slk:three times more likely;elm:context_link;itc:0;sec:content-canvas" class="link ">three times more likely</a> than white Americans to develop kidney failure.</p><p class="mb-4 text-lg md:leading-8 break-words">While Black people constitute only 12% of the U.S. population, they <a href="https://www.nytimes.com/2022/05/17/health/kidney-disease-black-americans.html" rel="nofollow noopener" target="_blank" data-ylk="slk:account for 35%;elm:context_link;itc:0;sec:content-canvas" class="link ">account for 35%</a> of those with kidney failure. The reason is due in part to the prevalence of diabetes and high blood pressure – the <a href="https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/causes" rel="nofollow noopener" target="_blank" data-ylk="slk:two largest contributors;elm:context_link;itc:0;sec:content-canvas" class="link ">two largest contributors</a> to kidney disease – in the Black community.</p><p class="mb-4 text-lg md:leading-8 break-words">Almost <a href="https://optn.transplant.hrsa.gov/data/" rel="nofollow noopener" target="_blank" data-ylk="slk:100,000 people;elm:context_link;itc:0;sec:content-canvas" class="link ">100,000 people</a> in the U.S. are awaiting kidney transplantation. Though Black Americans are more likely to need transplants, they are also <a href="https://theconversation.com/minorities-face-more-obstacles-to-a-lifesaving-organ-transplant-115038" rel="nofollow noopener" target="_blank" data-ylk="slk:less likely;elm:context_link;itc:0;sec:content-canvas" class="link ">less likely</a> to receive them.</p><p class="mb-4 text-lg md:leading-8 break-words">Making matters worse, kidneys from <a href="https://www.nbcnews.com/news/nbcblk/biased-test-kept-thousands-black-people-getting-kidney-transplant-s-fi-rcna145856" rel="nofollow noopener" target="_blank" data-ylk="slk:Black donors;elm:context_link;itc:0;sec:content-canvas" class="link ">Black donors</a> in the U.S. are more likely to be thrown away as a result of <a href="https://www.pbs.org/newshour/nation/a-racially-biased-test-kept-thousands-of-black-people-from-getting-a-kidney-transplant#" rel="nofollow noopener" target="_blank" data-ylk="slk:a flawed system;elm:context_link;itc:0;sec:content-canvas" class="link ">a flawed system</a> that erroneously considers all Black donor kidneys as more likely to stop working after a transplant than kidneys from donors of other races.</p><p class="mb-4 text-lg md:leading-8 break-words">As a scholar of bioethics, health and philosophy, I believe this flawed system raises serious ethical concerns about justice, fairness and good stewardship of a scarce resource – kidneys.</p><h2 class="mb-4 text-xl font-bold md:text-2xl">How did we get here?</h2><p class="mb-4 text-lg md:leading-8 break-words">The U.S. organ transplantation system rates donor kidneys using the <a href="https://optn.transplant.hrsa.gov/professionals/by-topic/guidance/kidney-donor-profile-index-kdpi-guide-for-clinicians/" rel="nofollow noopener" target="_blank" data-ylk="slk:kidney donor profile index;elm:context_link;itc:0;sec:content-canvas" class="link ">kidney donor profile index</a>, an algorithm that includes 10 factors, including the donor’s age, height, weight and history of hypertension and diabetes.</p><p class="mb-4 text-lg md:leading-8 break-words">Another factor in the algorithm is race.</p><p class="mb-4 text-lg md:leading-8 break-words">Research on <a href="https://doi.org/10.1034/j.1600-6143.2002.020112.x" rel="nofollow noopener" target="_blank" data-ylk="slk:previous transplants;elm:context_link;itc:0;sec:content-canvas" class="link ">previous transplants</a> shows that some kidneys donated by Black people are more likely to stop working sooner after transplantation than kidneys donated by people from other races.</p><p class="mb-4 text-lg md:leading-8 break-words">This brings down the average time a transplanted kidney from a Black donor can last for a patient.</p><figure class="relative mb-4"><div class="relative"><img alt="A human kidhey is shown sliced in half to show major blood vessels." loading="lazy" width="400" height="411" decoding="async" data-nimg="1" class="rounded-lg" style="color:transparent" src="https://s.yimg.com/ny/api/res/1.2/YGKl8lxUXDIwHLLD0eZ.AQ--/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNTtoPTcyNDtjZj13ZWJw/https://media.zenfs.com/en/the_conversation_us_articles_815/fdda034a9948d7ef1c29292fa0cb51c8"></div><figcaption class="relative text-sm mt-1 pr-2.5"><div style="max-height:none;overflow:visible">An image of a cross section of a kidney showing the major blood vessels. <a href="https://www.gettyimages.com/detail/news-photo/cross-section-of-the-right-kidney-showing-the-major-blood-news-photo/143064138?adppopup=true" rel="nofollow noopener" target="_blank" data-ylk="slk:Encyclopaedia Britannica/UIG Via Getty Images;elm:context_link;itc:0;sec:content-canvas" class="link ">Encyclopaedia Britannica/UIG Via Getty Images</a></div></figcaption></figure><p class="mb-4 text-lg md:leading-8 break-words">As a result, kidneys donated by Black people are <a href="https://doi.org/10.2215/CJN.01510218" rel="nofollow noopener" target="_blank" data-ylk="slk:discarded at higher rates;elm:context_link;itc:0;sec:content-canvas" class="link ">discarded at higher rates</a> because the algorithm downgrades their quality based on the donor’s race.</p><p class="mb-4 text-lg md:leading-8 break-words">This means that <a href="https://www.sciencedirect.com/science/article/pii/S160061352225014X" rel="nofollow noopener" target="_blank" data-ylk="slk:some good kidneys;elm:context_link;itc:0;sec:content-canvas" class="link ">some good kidneys</a> may be wasted, raising several ethical and practical concerns.</p><h2 class="mb-4 text-xl font-bold md:text-2xl">Risk, race and genetics</h2><p class="mb-4 text-lg md:leading-8 break-words">Scientists have shown that races are <a href="https://www.scientificamerican.com/article/race-is-a-social-construct-scientists-argue/" rel="nofollow noopener" target="_blank" data-ylk="slk:social constructs;elm:context_link;itc:0;sec:content-canvas" class="link ">social constructs</a> that are poor indicators of human genetic diversity.</p><p class="mb-4 text-lg md:leading-8 break-words">Using a donor’s race assumed people who belong to the same socially constructed group share important biological characteristics despite evidence that there is more genetic variation <a href="https://doi.org/10.1101/cshperspect.a008524" rel="nofollow noopener" target="_blank" data-ylk="slk:within racial groups;elm:context_link;itc:0;sec:content-canvas" class="link ">within racial groups</a> than between other racial groups. Such is the case for Black Americans.</p><p class="mb-4 text-lg md:leading-8 break-words">It is possible that the explanation for observed differences in outcomes lies in genetics and not in race.</p><p class="mb-4 text-lg md:leading-8 break-words">People who have two copies of certain forms or <a href="https://www.kidney.org/atoz/content/apol1-mediated-kidney-disease-amkd#" rel="nofollow noopener" target="_blank" data-ylk="slk:variants of the APOL1 gene;elm:context_link;itc:0;sec:content-canvas" class="link ">variants of the APOL1 gene</a> are more likely to develop kidney disease.</p><p class="mb-4 text-lg md:leading-8 break-words">About 85% of people with those variants never develop kidney disease, but 15% do. Medical researchers do not yet understand what is behind this difference, but genetics is likely only part of the story. Environment and exposure to certain viruses are also possible explanations.</p><p class="mb-4 text-lg md:leading-8 break-words">People who have two copies of the <a href="https://doi.org/10.1093/ndt/gfr522" rel="nofollow noopener" target="_blank" data-ylk="slk:riskier forms of the APOL1 gene;elm:context_link;itc:0;sec:content-canvas" class="link ">riskier forms of the APOL1 gene</a> almost all have ancestors who came from Africa, especially from West and sub-Saharan Africa. In the U.S., such people typically are categorized as Black or African American.</p><p class="mb-4 text-lg md:leading-8 break-words">Research on kidney transplants suggests that kidneys from donors with two copies of the higher-risk APOL1 variants <a href="https://doi.org/10.1097/TP.0000000000000969" rel="nofollow noopener" target="_blank" data-ylk="slk:fail at higher rates;elm:context_link;itc:0;sec:content-canvas" class="link ">fail at higher rates</a> after transplantation. This could explain the data on Black donor kidney failure rate.</p><h2 class="mb-4 text-xl font-bold md:text-2xl">How might this practice change?</h2><p class="mb-4 text-lg md:leading-8 break-words">Health care professionals decide how limited resources are used and distributed. With that comes an ethical responsibility to steward resources fairly and wisely, which includes preventing unnecessary loss of transplantable kidneys.</p><p class="mb-4 text-lg md:leading-8 break-words">Reducing the number of wasted kidneys is important for another reason.</p><figure class="relative mb-4"><div class="relative"><img alt="A black man raises his gown as a doctor uses a marker to  show which kidney is to be removed during surgery." loading="lazy" width="960" height="641" decoding="async" data-nimg="1" class="rounded-lg" style="color:transparent" src="https://s.yimg.com/ny/api/res/1.2/j9bOTHiUR87Hqwcd3Zxejg--/YXBwaWQ9aGlnaGxhbmRlcjt3PTk2MDtoPTY0MTtjZj13ZWJw/https://media.zenfs.com/en/the_conversation_us_articles_815/99a563658e7fa4d21e9a3682f126875d"><button aria-label="View larger image" class="group absolute bottom-3 right-3 size-10 md:size-[50px] lg:inset-0 lg:size-full lg:bg-transparent" data-ylk="elm:expand;itc:1;sec:image-lightbox;slk:lightbox-open;"><span class="absolute bottom-0 right-0 rounded-full bg-white p-3 opacity-100 shadow-elevation-3 transition-opacity duration-300 group-hover:block group-hover:opacity-100 md:p-[17px] lg:bottom-6 lg:right-6 lg:bg-white/90 lg:p-5 lg:opacity-0 lg:shadow-none"><svg viewbox="0 0 22 22" aria-hidden="true" class="size-4 lg:size-6" width="22" height="22"><path d="M12.372.92c0-.506.41-.916.915-.916L21 0l-.004 7.712a.917.917 0 0 1-1.832 0V3.183l-6.827 6.828-1.349-1.348 6.828-6.828h-4.529a.915.915 0 0 1-.915-.915M1.835 17.816l6.828-6.828 1.349 1.349-6.829 6.827h4.529a.915.915 0 0 1 0 1.831L0 21l.004-7.713a.916.916 0 0 1 1.831 0z"></path></svg></span></button><dialog aria-label="Modal Dialog" aria-modal="true" class="fixed inset-0 z-4 size-full max-h-none max-w-none bg-white hidden"></dialog></div><figcaption class="relative text-sm mt-1 pr-2.5"><div style="max-height:none;overflow:visible">A doctor at Johns Hopkins Hospital marks which kidney to remove from a living Black donor. <a href="https://www.gettyimages.com/detail/news-photo/dr-dorry-segev-marks-which-kidney-to-remove-on-a-kidney-news-photo/147200067?adppopup=true" rel="nofollow noopener" target="_blank" data-ylk="slk:Brendan Smialowski/AFP/GettyImages;elm:context_link;itc:0;sec:content-canvas" class="link ">Brendan Smialowski/AFP/GettyImages</a></div></figcaption></figure><p class="mb-4 text-lg md:leading-8 break-words">Many people agree to organ donations to help others. Black donors may be disturbed to learn that their kidneys are more likely to be discarded because they came from a Black person.</p><p class="mb-4 text-lg md:leading-8 break-words">This practice can further <a href="https://www.commonwealthfund.org/publications/newsletter-article/2021/jan/medical-mistrust-among-black-americans" rel="nofollow noopener" target="_blank" data-ylk="slk:decrease the trust;elm:context_link;itc:0;sec:content-canvas" class="link ">decrease the trust</a> of Black Americans in a health care system that has a long history of mistreating Black people.</p><p class="mb-4 text-lg md:leading-8 break-words">Making organ transplantation more equitable could be as simple as <a href="https://hrsa.unos.org/policies-bylaws/public-comment/refit-kidney-donor-profile-index-without-race-and-hepatitis-c-virus/" rel="nofollow noopener" target="_blank" data-ylk="slk:ignoring race;elm:context_link;itc:0;sec:content-canvas" class="link ">ignoring race</a> when evaluating donor kidneys, as some medical researchers have proposed.</p><p class="mb-4 text-lg md:leading-8 break-words">But this approach would not account for the observed difference in transplantation outcomes and could result in transplanting some kidneys that are at increased risk for early failure due to a genetic issue.</p><p class="mb-4 text-lg md:leading-8 break-words">And since Black kidney recipients are more likely to receive <a href="https://doi.org/10.1111/ajt.14113" rel="nofollow noopener" target="_blank" data-ylk="slk:kidneys from Black donors;elm:context_link;itc:0;sec:content-canvas" class="link ">kidneys from Black donors</a>, this approach could perpetuate transplant disparities.</p><p class="mb-4 text-lg md:leading-8 break-words">Another option that would improve public health and reduce racial health disparities is to identify the factors that lead to some kidneys donated by Black people to fail at higher rates.</p><p class="mb-4 text-lg md:leading-8 break-words">One way researchers are working to identify higher risk kidneys is using the <a href="https://doi.org/10.2215/CJN.01510218" rel="nofollow noopener" target="_blank" data-ylk="slk:APOLLO study;elm:context_link;itc:0;sec:content-canvas" class="link ">APOLLO study</a>, which assesses the impact of key variants on donated kidneys.</p><p class="mb-4 text-lg md:leading-8 break-words">In my view, using the variant instead of race likely would decrease the number of kidneys wasted while protecting recipients from kidneys that are likely to stop working sooner after transplantation.</p><p class="mb-4 text-lg md:leading-8 break-words"><em>This article is republished from <a href="http://theconversation.com/us?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=related-link-0&amp;utm_content=article-225546" rel="nofollow noopener" target="_blank" data-ylk="slk:The Conversation;elm:context_link;itc:0;sec:content-canvas" class="link ">The Conversation</a>, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: <a href="https://theconversation.com/profiles/ana-s-iltis-1517748?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=byline-link&amp;utm_content=article-225546" rel="nofollow noopener" target="_blank" data-ylk="slk:Ana S. Iltis;elm:context_link;itc:0;sec:content-canvas" class="link ">Ana S. Iltis</a>, <em><a href="https://theconversation.com/institutions/wake-forest-university-1709?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=byline-link&amp;utm_content=article-225546" rel="nofollow noopener" target="_blank" data-ylk="slk:Wake Forest University;elm:context_link;itc:0;sec:content-canvas" class="link ">Wake Forest University</a></em> </em></p><p class="mb-4 text-lg md:leading-8 break-words"><strong>Read more:</strong><br></p><ul class="mb-4"><li class="ml-4 list-disc"><div class=""><p class="mb-4 text-lg md:leading-8 break-words"><a href="http://theconversation.com/trumps-order-for-more-action-on-kidney-disease-may-shrink-organ-transplant-waitlists-116411?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=related-link0&amp;utm_content=article-225546" rel="nofollow noopener" target="_blank" data-ylk="slk:Trump’s order for more action on kidney disease may shrink organ transplant waitlists;elm:context_link;itc:0;sec:content-canvas" class="link ">Trump’s order for more action on kidney disease may shrink organ transplant waitlists</a></p></div></li><li class="ml-4 list-disc"><div class=""><p class="mb-4 text-lg md:leading-8 break-words"><a href="http://theconversation.com/including-race-in-clinical-algorithms-can-both-reduce-and-increase-health-inequities-it-depends-on-what-doctors-use-them-for-206168?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=related-link1&amp;utm_content=article-225546" rel="nofollow noopener" target="_blank" data-ylk="slk:Including race in clinical algorithms can both reduce and increase health inequities – it depends on what doctors use them for;elm:context_link;itc:0;sec:content-canvas" class="link ">Including race in clinical algorithms can both reduce and increase health inequities – it depends on what doctors use them for</a></p></div></li><li class="ml-4 list-disc"><div class=""><p class="mb-4 text-lg md:leading-8 break-words"><a href="http://theconversation.com/minorities-face-more-obstacles-to-a-lifesaving-organ-transplant-115038?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=related-link2&amp;utm_content=article-225546" rel="nofollow noopener" target="_blank" data-ylk="slk:Minorities face more obstacles to a lifesaving organ transplant;elm:context_link;itc:0;sec:content-canvas" class="link ">Minorities face more obstacles to a lifesaving organ transplant</a></p></div></li></ul><p class="mb-4 text-lg md:leading-8 break-words"><em><span>Ana S. Iltis is a funded investigator on the APOLLO study and receives funding from the National Institutes of Health</span></em></p></div>

As it is now, the transplant system treats kidneys from all Black donors as if they are at higher risk for failing, even though only some are.

Kidneys from Black donors are more likely to be thrown away − a bioethicist explains why

Sports have the ability to dazzle and motivate, and a few occasions carve themselves into our recollections until the end of time. From record-breaking accomplishments


The 10 Most Significant Games in History


Picking the right bike for regular use can upgrade your driving experience, advance a sound way of life, and diminish your ecological


5 Bike Brands for Ordinary Use


Positive nurturing is a methodology that spotlights on sustaining and supporting youngsters through uplifting feedback, successful correspondence, and setting clear


Find the Advantages of Positive Nurturing: Supporting Cheerful and Sound Kids


Blossoms have an extraordinary approach to bringing excellence, happiness, and scent into our lives. Each kind of bloom has its


Vote In favor of Your Number one Sort Of Blossoms


The live-action adaptation of the beloved Disney flick was first announced in December 2024.

'Tangled' live-action movie casts Teagan Croft and Milo Manheim as Rapunzel and Flynn

Some experts say red meat and full-fat dairy can be high in saturated fats.

RFK Jr.'s diet guidelines emphasize red meat, full-fat dairy. How healthy are they?

Working on the web has become progressively well known, offering adaptability, comfort, and the potential chance to make money from anyplace in the


From Lounge chair to Money: Online Positions That Will Change Your Profession


The first scientific balloon flight happened on Dec. 16, 2025.

NASA launches science balloon in Antarctica | Space photo of the day for Dec. 22, 2025

On Episode 187 of This Week In Space, Rod Pyle and Tariq Malik talk with Glen Swanson, author of the new Star Trek history book "Inspired Enterprise."

This Week In Space podcast: Episode 187 — An Inspired Enterprise

Elaine Hendrix, Alix Earle, Dylan Efron, Jordan Chiles and Robert Irwin will all be taking the stage for their final dances of the season.

'Dancing With the Stars' Season 34 finale: Who might win the mirror ball trophy? Where do the remaining contestants rank?

A British court ruled Friday that Australian mining giant BHP is liable for one of Brazil's worst environmental disasters, potentially paving the way for billions of dollars in compensation. BHP on Friday said it would appeal the ruling.

BHP liable for 2015 Brazil mine disaster: UK court

A flu strain that emerged over the summer is causing outbreaks in other countries. The CDC hasn't provided any insights on what's happening in the U.S. in weeks.

Warnings rise for U.S. as severe flu strain causes outbreaks in Canada, U.K.

The park is named after Belfast-born and Dublin-raised Chaim Herzog, a former president of Israel.

Council removes proposal to rename park named after former president of Israel

SpaceX launched the first mission of 2026 tonight (Jan. 2), sending an Italian Earth-observing satellite to orbit.