Negative Effects of Organ Transplants | Vernellia R. Randallmm Professor of Law and Web Editor

The Negative Effect of Organ Transplantation and Access on Ethnic Minorities in the United States

Annotated Bibliography


For patients on long-term dialysis, receiving a healthy kidney from a donor offers a longer life span, an improved quality of life and lower overall health care costs. (1) However, for most minorities, especially African Americans, disparities exist between the allocation of scarce organs compared to White Americans. The term minorities include African Americans, Hispanics/Latinos, Asian Americans and Native Americans.

This bibliography focuses primarily on African Americans because of the amount of data available and as a group, African Americans are most negatively impacted by current policies. In addition, they represent the largest minority population in the United States. Despite Medicare financing for kidney transplantation, African Americans are still worse off in comparison to rich white males. (2) Most recent data indicates that one-third of patients with end stage renal disease (ESRD) are African American, but are recipients of only 22% of the kidneys. (3)

In 1984, Congress passed the National Organ Transplant Act (NOTA) with the objective to support a rational and fair national health policy. (4) NOTA requires the Secretary of the Department of Health and Human Services (HHS) to "by contract provide for the establishment and operation of an Organ Procurement and Transplantation Network (OPTN)" through which the procurement, distribution and transplantation of human organs is organized. (5) In 1986, the Department of HHS awarded the OPTN contract to the United Network for Organ Sharing, Inc. (UNOS) a private non-profit entity, for the establishment and implementation of the federal OPTN. UNOS, as part of its obligations adopts principles and procedures for the distribution of organs for transplantation, maintains a computer registry of persons requiring an organ transplant, collects national data on transplantation frequency and results and also develop rules for organ allocation. (6) As mandated by 42 U.S.C.A. § 1330b-8, hospitals with transplant programs must abide by UNOS rules or lose their Medicare and Medicaid funding. Continue reading