An effort to remedy harm from a race-based kidney test helps Black
patients seeking transplants
[March 10, 2026]
By LAURAN NEERGAARD
WASHINGTON (AP) — An unprecedented effort to reverse the effects of a
racially biased medical test that blocked or delayed Black people from
getting kidney transplants seems to be working.
Researchers reported Monday that thousands of Black transplant
candidates have been given credit on the transplant waiting list for
time they lost because of that misguided test, moving up their priority
in an attempt at restorative justice.
That test used a race-based formula to calculate patients’ kidney
function. It made Black patients’ kidneys appear healthier than they
really were, delaying diagnosis of impending organ failure and referral
for transplant.
After the U.S. transplant system ended use of the race-based test, it
ordered hospitals to determine which Black patients on their transplant
lists could have qualified for a new kidney sooner, by combing medical
records for long-ago biased findings, and credit them with that time.
Researchers at Beth Israel Deaconess Medical Center, Brigham and Women’s
Hospital and Boston Medical Center analyzed a database of all kidney
transplants between January 2022 and June 2025, comparing transplant
rates before and after the January 2023 policy change.
Among the more than 21,000 Black transplant candidates given waiting
time modifications, the median gain was 1.7 years, the team reported in
JAMA Internal Medicine. That's meaningful time as the wait for a kidney
transplant averages three to five years but can be far longer in some
parts of the country.
Black patients’ transplant rate increased right after the policy change,
by 5.3 transplants per 1,000 listings, before leveling off. Overall the
kidney transplant rate increased during the study period and the the
transplant rate for non-Black patients didn't change significantly under
the new policy, remaining highest for white patients., the researchers
reported.
The findings “suggest that improving transplant care for Black
individuals did not harm individuals of other races,” Dr. L. Ebony
Boulware of Wake Forest University School of Medicine, who wasn’t
involved in the study, wrote in an accompanying commentary that urges
similar efforts to mitigate harm from other erroneously race-based
medical tests.
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A sign hangs from the Beth Israel Deaconess Medical Center, Aug. 18,
2022, in Boston. (AP Photo/Charles Krupa, file)
 The policy “hopefully helps move the
needle toward equity,” Dr. Rohan Khazanchi of Brigham and Women’s
Hospital and Boston Medical Center, who led the study, said in an
interview.
Getting a wait-time credit didn't translate into immediate
transplants — 7,484 of them received a new kidney during the study
period.
The biased kidney test was based on a measurement of how quickly a
waste compound called creatinine gets filtered from blood. In 1999,
an equation used to calculate that rate was modified to adjust Black
people’s results compared to everyone else’s, based on some studies
with small numbers of Black patients and a long-ago false theory
about differences in creatinine levels.
That test exacerbated other disparities that already make Black
Americans more at risk of needing a new kidney but less likely to
get one. They are over three times more likely than white people to
experience kidney failure and make up about 30% of the kidney
transplant list.
Khazanchi was surprised to find that less than 1 of 3 Black
transplant candidates received wait-time modifications.
That might be because some weren’t diagnosed with kidney disease
until their organs had failed, an emergency that doctors call
“crashing onto dialysis.” But Khazanchi said another possibility is
that some transplant centers had more resources than others to do
the digging into old medical records – lab tests performed not only
years earlier but possibly in different health systems in different
parts of the country – to find everyone who qualified.
While the ordered lookback to change wait times happened in 2023,
Black patients more recently added to the transplant list should ask
if they also may be eligible, he advised.
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