Black Man Awaiting Kidney Transplant Blames Racism

An African-American is seeking millions of dollars in damages and a lawsuit to get a better spot on a kidney transplant waiting list, claiming the system used to determine priority for organs is biased against black people.

Anthony Randall filed suit last week against an affiliate of Cedars-Sinai Hospital in Los Angeles, where he was listed as a transplant patient, and the United Network for Organ Sharing, a nonprofit organization that runs the U.S. transplant system.

Randall — a Los Angeles barber who can no longer work due to kidney disease, receives dialysis treatments three times a week and has been waiting more than five years for a kidney — also wants a federal court to allow him to represent 27,500 blacks. American patients, he argues, are similarly disadvantaged.

“The racial discrimination described above harmed Plaintiff and members of the Nationwide Waiting List Class, the California Waiting List Class, and the Cedars-Sinai Class by depriving and/or delaying a donor kidney,” Randall’s suit contends. All have suffered “economic injuries,” including dialysis and other medical expenses, it said.

Both UNOS and Cedars-Sinai have in recent months abandoned the use of the portion of the formula that Randall cited in his lawsuit. In June, the Transplant Organization’s Board of Directors noted that “the inclusion of a modifier for black-identified patients … has led to a systematic underestimation of the severity of kidney disease in many black patients. Particularly in organ transplants, this may have negatively affected transplant list times or transplant wait times.” It may have negatively affected the candidates qualifying date to begin with.

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In January, UNOS advised hospitals to stop using that part of the algorithm and inform black patients waiting for kidneys that they are eligible to have their “added wait time” adjusted — a critical factor in determining the order of potential recipients for a kidney. are in short supply. Randall says he might have qualified for a kidney if that adjustment had been made sooner.

According to Randall’s lawsuit, Cedars complied with UNOS’ order on March 27, saying it would begin a review that could take months. Randall insists there is no hospital or transplant The system moves fast.

As of April 5, when the lawsuit was filed, Randall’s “wait times were miscalculated in UNOS’s UNet software, miscalculating the plaintiff’s candidacy for a donor kidney from the national kidney waiting list,” the suit contends.

A UNOS spokesperson said the organization would take up the matter in court. “As this is an active case, no further details can be provided at this time,” Anne Baske wrote in an email.

In a statement, Cedars-Sinai said it cannot discuss individual patients, but “as an organization founded on equity, diversity and inclusion, Cedars-Sinai remains committed to the health and well-being of all in our care.”

The case is the latest attempt to challenge the policies and operation of the country’s complex organ transplant system in recent years. Two similar lawsuits were filed in federal courts in New York and Washington in 2021 and 2o22.

Last month, the government announced plans to overhaul the entire exchange system, including breaking up the monopoly that has operated since 1986.

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A Senate committee that has been investigating long-standing problems in the system for three years released a critical report in August that held UNOS and organizations across the country responsible for 70 unnecessary deaths and 249 illnesses in screening organs used for lapses. Transplant surgery.

A government technology watchdog has called for a complete overhaul of the archaic system of moving organs from hospitals to recipients.

The main concern for transplant patients is that there are about 104,000 people on the waiting list, most of whom are seeking kidneys. By calculation, 17 to 33 of them wait for kidneys, livers, lungs, hearts and other organs every day.

There is widespread agreement that the system is racially imbalanced. Blacks are three times more likely to develop kidney disease than whites But the chance of getting laid is very low Get on a transplant waiting list or kidney.

In a 2022 report, the National Academies of Sciences, Engineering, and Medicine cited research showing that blacks are less likely than whites to be judged as suitable candidates for transplants; Blacks are 37 percent less likely than whites to be referred for replacement therapy before they need dialysis; And blacks wait an average of 727 days for kidneys after being placed on the waiting list, while whites wait an average of 374 days.

Randall’s case points to another problem. Time on the waiting list is part of the calculus that determines which patients get the first shot at kidneys. Placement on the list depends on her falling below a threshold that indicates poor kidney function, according to her lawsuit.

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The implausible research suggests that blacks reach that limit sooner than whites because they produce more muscle and more of the amino acid creatine — part of a measure used to determine how poorly the kidneys are working. In designing the mechanism for prioritizing kidney transplants, the transplant system used a 16 percent to 18 percent “switch” to balance the advantage for blacks.

Randall argues that the formula disadvantaged him and other blacks for decades. He insisted he was second in line for a kidney in December and was called to the hospital to be prepped for surgery – but it wasn’t available. He insisted that if his actual waiting time had been part of the calculation, he could have received the organ.

“He has been consistently delayed in the process of getting a kidney,” said Randall’s attorney, Matthew L. Venezia said. “They could have adjusted his wait time,” he said of Cedars-Sinai. “They don’t … a lot of these patients don’t even have 18 months.”

Venezia said Randall is seeking more than $5 million for himself and other blacks on the kidney transplant waiting list, as well as an immediate recalculation of his wait time so he can be in a better position once a kidney is available. .

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