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Leadership Blog

What Transplant Equity Is and How to Access It

By Dr. Bradley Lembcke, CMO, Senior Vice President and Chief Medical Officer of St. Luke’s Health

July 21, 2023 Posted in: Leadership

 

In certain situations when nothing else works, organ transplantation is a life-changing, life-saving treatment option. However, the road to transplantation can have obstacles. 

One challenge is the number of donors. There simply aren’t enough to go around. As a result, receiving an organ donation often involves a waiting list. Those in need of transplant may wait months or even years to receive their organ. Others may never receive an organ.

Another barrier that patients face is lack of transplant equity. At St. Luke’s Health, health equity has been on our radar for years, and we work hard to ensure equal access to care for all of our transplant candidates. 

Understanding Equity in Organ Transplants

To understand the need for transplant equity, it’s helpful to know how equity compares to equality. Young Leaders of the Americas Initiative says, “equality means ‘sameness,’ and equity means ‘fairness.’”

Why is there a need for equity or fairness? If you think all ethnicities have the same access to transplantation, consider this research cited by the National Institutes of Health. Compared to white patients, Black patients are:

  • Less than half as likely to have their primary care physician consider them kidney transplant candidates

  • More likely to feel pressured by organ procuring organizations but statistically less likely to get approached to donate in the first place

  • 37 percent less likely to be referred for kidney transplant evaluation before transplantation is necessary

  • Half as likely to be listed for kidney transplant before exhausting all other treatment options

  • Nearly 60 percent less likely to undergo kidney transplantation through a living donor 


Treatment of Black patients is not the only inequity. Transplant inequity also affects those of Asian American, American Indian and Latino heritage. Women are at a disadvantage as well. So are people with intellectual disabilities and those of lower socioeconomic status.

Equity aims to minimize or eliminate the above statistics. With true equity, all people in need of a transplant are educated, referred, added to wait lists and transplanted at equal rates.

Addressing Transplant Equity

Because organ transplantation belongs to everyone, SLH works to make it accessible. Our efforts are paying off. Year after year, the number of minority patients who undergo transplantation at SLH is higher than regional and national averages. Our liver transplant program serves nearly 20 percent more Black and Latino patients than the national average. Almost half of our heart transplant recipients are Black, twice the rate across America.

Of course, we have room to grow and improve, so we hope to make transplant more readily available for all. One way we do this is by teaching patients about transplant equity and examining social determinants of care. 

These social factors make certain people less likely to access all sorts of health care, including transplantation. They also make it more difficult for certain people to get on the transplant wait list.

Social determinants that make someone less likely to get on the transplant wait list and become organ recipients include:

  • Lack of transportation to and from appointments

  • Inadequate insurance coverage or difficulty understanding coverage

  • Not having a strong support network that can help navigate the transplant process


SLH actively addresses these issues and more through our Community Investment Program. We also make it easier for residents of all ethnicities to access the transplants they need by providing various transplant options close to home. 

Organs we transplant include:

  • Heart

  • Kidney

  • Liver

  • Lung


When a heart isn’t available for immediate transplant, we can implant a left ventricular assist device. This can keep your heart beating until a transplant is available. We also accept organs from both deceased and living donors, opening the door to more transplant opportunities.

Your Role in Equity

While SLH does our part to enhance transplant equity. you play a role, as well. It starts by understanding the need for transplant equity and talking about it. But your involvement goes beyond knowledge. To advance transplant equity, you are empowered to take action.

If you plan to donate your organs when you die, tell your loved ones and your doctor. Put your intent in writing and add it to your will. Take care to make your wishes crystal clear, leaving no doubt about your desire.

Want to help right now? Consider becoming a living donor. By doing this, you give someone a second chance at life while you’re still alive. Currently, living donors can donate the following organs:

  • Intestine (You donate part.)

  • Kidney (You donate one of your two kidneys.)

  • Liver (You donate part, and the remaining liver regrows until it is nearly as big as it was pre-donation.)

  • Lung (You donate a single lobe.)

  • Pancreas (You donate part.)

Living Donors Live Well

As a living donor, you can gift your organ to a patient of your choosing or a stranger. Your role in the transplant process is free of charge. The recipient’s insurance typically covers all your expenses.

Following your donation, you will need to rest for a period of time. You may need to take time off work and sideline your exercise routine. Once you recover fully, you should be able to resume your daily activities. Some people even enjoy a higher quality of life after donation.

To encourage more living donors, SLH partners with The Organ Trail. This unique organization shows how active living donors can be post-transplant. Through The Organ Trail, a 67-year-old living kidney donor recently cycled 1,500 miles, riding from Texas, including a stop at Baylor St. Luke’s Medical Center’s McNair Campus, to Louisiana. Along the way, the donor spread living donor awareness and showed that life goes on after donation, for the donor and recipient.

Whether or not you choose to ride thousands of miles on a bicycle, consider supporting transplant equity by becoming an organ donor.

 

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