To the Editor.
—Dr Gaston and colleagues1 describe some of the factors that contribute to racial disparity in end-stage renal disease and transplantation in the United States. They set forth the premise that HLA matching, as used in the current kidney allocation system, is responsible for perceived racial inequities in kidney transplantation. However, the authors fail to clearly demonstrate a causal relationship between the role of HLA matching in the current renal allocation system and unequal renal transplant waiting times observed across racial groups. Data analyzed for a United Network for Organ Sharing (UNOS) research report, being prepared for publication in 1994, indicate that the distribution of renal offers according to patient race is much more equitable than one might expect after examining waiting time differences across racial groups. Data to be reported show that every time a kidney becomes available, many factors come into play after patients on
Norman DJ. Racial Inequities in Kidney Transplantation: The UNOS Perspective. JAMA. 1994;271(18):1402-1403. doi:10.1001/jama.1994.03510420034024