A groundbreaking initiative to address racial bias in medical testing that prevented Black patients from receiving timely kidney transplants is showing positive results, according to new research.
Scientists announced Monday that more than 21,000 Black transplant candidates have received additional waiting list credits to compensate for time lost due to discriminatory testing practices, advancing their position in line for organ transplants as part of a restorative justice approach.
The problematic test employed a race-based calculation to assess kidney function levels. This flawed methodology caused Black patients’ kidney health to appear better than the actual condition, postponing critical diagnoses of organ failure and transplant referrals.
Following the elimination of race-based testing from the U.S. transplant network, medical facilities were mandated to review their transplant rosters and identify Black patients who should have qualified for kidney transplants earlier by examining historical medical data for previously biased results, then awarding appropriate time credits.
Medical researchers from Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, and Boston Medical Center examined transplant data spanning January 2022 through June 2025, evaluating transplant statistics before and after the January 2023 policy revision.
The research team found that among Black transplant candidates who received waiting time adjustments, the typical credit was 1.7 years, according to findings published in JAMA Internal Medicine. This represents significant time considering kidney transplant waits typically range from three to five years, though some regions experience much longer delays.
Following the policy implementation, Black patients experienced an immediate boost in transplant rates by 5.3 transplants per 1,000 listings before stabilizing. The overall kidney transplant rate grew throughout the research period, while transplant rates for non-Black patients showed no significant changes under the updated policy, with white patients maintaining the highest rates, researchers found.
“The results suggest that improving transplant care for Black individuals did not harm individuals of other races,” wrote Dr. L. Ebony Boulware of Wake Forest University School of Medicine, who was not part of the research team, in a related commentary advocating for similar measures to address damage from other incorrectly race-based medical assessments.
“Hopefully this policy helps move the needle toward equity,” stated Dr. Rohan Khazanchi of Brigham and Women’s Hospital and Boston Medical Center, the study’s lead researcher, during an interview.
Receiving wait-time credits did not result in instant transplants — 7,484 patients obtained new kidneys during the research timeframe.
The discriminatory kidney assessment relied on measuring how rapidly creatinine, a waste product, gets eliminated from the bloodstream. In 1999, the calculation formula was altered to modify Black patients’ results compared to other groups, drawing from limited studies involving small numbers of Black participants and an outdated incorrect theory regarding creatinine level differences.
This biased testing worsened existing inequalities that already put Black Americans at higher risk for needing kidney replacement while reducing their chances of receiving one. They face over three times the likelihood of kidney failure compared to white individuals and represent approximately 30% of kidney transplant candidates.
Khazanchi expressed surprise that fewer than one in three Black transplant candidates received waiting time adjustments.
This could stem from some patients not being diagnosed with kidney disease until organ failure occurred, a critical situation medical professionals term “crashing onto dialysis.” However, Khazanchi suggested another explanation might be that certain transplant facilities had better resources than others to search through historical medical files — laboratory results conducted years earlier and potentially at different healthcare systems across the country — to identify all eligible individuals.
Although the mandated review to modify wait times occurred in 2023, Black patients recently added to transplant lists should inquire about potential eligibility, he recommended.
