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Modify Waiting Time for Candidates Affected by Race-Inclusive Estimated Glomerular Filtration Rate (eGFR) Calculations

eye iconAt a glance

Current policy

In June of 2022, the Board of Directors approved Establish OPTN Requirement for Race-Neutral eGFR Calculations, which prohibits the use of race-inclusive calculations. A race-inclusive calculation can overestimate a Black candidates’ eGFR value and result in a delayed start of waiting time accrual to receive a kidney transplant. Current OPTN policy does not provide a pathway for registered candidates who have been impacted by a race-inclusive eGFR calculation to regain waiting time they could have received if a race-neutral calculation was used to estimate their GFRs.

Supporting media

Presentation

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Proposed changes

  • Provide transplant programs a 365-day timeframe to assess their waiting lists, gather required documentation, and submit eGFR waiting time modifications for the affected Black candidates on their waiting lists
  • Transplant program participation is encouraged, but not mandatory

Anticipated impact

  • What it's expected to do
    • Waiting time will be restored to registered Black kidney candidates whose waiting time was affected by race-inclusive eGFR calculations that meet documentation and timeframe criteria
    • Increase equity in access to transplantation by providing programs the opportunity to request eGFR waiting time modifications for affected registered candidates
  • What it won't do
    • Mandate transplant program participation

Terms to know

  • Estimated glomerular filtration rate (eGFR): A tool used to measure how well a patient’s kidneys are functioning
  • Race-neutral eGFR calculation: A tool that calculates eGFR without the use of a race variable

Click here to search the OPTN glossary

Provide feedback

eye iconComments

LifeGift | 08/11/2022

Important step to address / adjust for previous disparities in waiting times based on race. Should be mandatory application, not optional by program.

Milton Mitchell | 08/11/2022

In support of this change. More importantly, mandatory requirement of all transplant centers is necessary - Please include. Thank you.

Nicole Seefeldt | 08/08/2022

It’s long past time to treat this long standing disparity. I’m for any policy that increases equality for marginalized groups due to racism, stigma and bias. This issue needs attention. It’s been a glaring problem for years. People have died and been harmed by lack of action on this issue. Medical racism needs to be abolished.

Kenny Laferriere | 08/08/2022

I support this change but I believe it should be a mandatory requirement of all transplant centers. I am unsure why it would be optional. How can we provide equity for all patients across the country if centers can choose to not participate.

Rebecca Baranoff | 08/07/2022

I support this proposal however I think it should be mandatory for all transplant programs to participate. I do not however support the idea of participating programs being responsible for assessing their waiting list for qualifying candidates. If this is the only way to modify the candidates waiting time, then there should be guidelines for a program to follow so that all possible candidates are viewed and reviewed to ensure all those affected by the Race-inclusive eGFR are given a fair opportunity for a modified waiting time. My additional questions are: 1. How will the candidates time be updated? What method will be used?

Kidney Donor Conversations | 08/04/2022

Support this measure to regain waiting time for Blacks with revisions: - Make it mandatory for all centers and allow ALL Patients to benefit. - If OPTN is not going to mandate, in order to be transparent, provide this information to all Black patients on the waiting list so they can be informed of this change and advocate for themselves to have the transplant center submit the necessary information.