[Skip to Content]
[Skip to Content Landing]
Views 540
Citations 0
Invited Commentary
April 3, 2019

Barriers to Kidney Transplant—The Devil Is in the Details

Author Affiliations
  • 1Solid Organ Transplantation, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
JAMA Surg. 2019;154(7):625-626. doi:10.1001/jamasurg.2019.0541

In 1984, the US Congress passed the National Transplant Organ Act to assure equitable access by patients to transplants and the allocation of donated organs among transplant centers.1 While older systems of kidney allocation were established for years, imbalances in recipients receiving kidney transplants became apparent.2 The new kidney allocation system (KAS) addressed the shortcomings of the old system by focusing on prioritizing candidates for “longevity matching,” wait-listed patients who were highly sensitized and waiting from the time of the first day of dialysis, but also by improving access for minority and underserved populations.2 The potential factors for these disparities include poverty, geography, and limited education about transplants.3,4 While progress has been made in increasing renal transplants post-KAS in African American recipients,5 disparities still exist when focusing on the wait-listing of minority groups, specifically African American individuals.6

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words