Focusing on Systems and Policies to Solve the Kidney Transplant Equity Crisis

Minoritized individuals in the US experience both disproportionally high rates of kidney failure and low rates of kidney transplant.These disparities create an urgent health crisis, since kidney transplant is a superior treatment for kidney failure, resulting in a 30% to 70% lower risk of death and substantially improved quality of life compared to dialysis. 1 Among transplant options, living donor kidney transplant (LDKT) offers superior outcomes.However, only 30% of all kidney transplants result from LDKT.Furthermore, profound inequities in LDKT for Black and other minoritized individuals have been present for decades.In 1995 to 1999, minoritized individuals were between 17% (Hispanic or Latino individuals) and 55% (Black individuals) less likely than White individuals to receive LDKT.Disparities have worsened over time such that in 2010 to 2014, minoritized individuals were between 48% (Hispanic or Latino individuals) and 73% (Black individuals) less likely to receive LDKT when compared to their White counterparts. 2These stark disparities are heavily influenced-but not entirely explained-by differences in individuals' health care access and socioeconomic status.Adults older than 65 years are also less likely