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(Circulation. 2000;101:e37.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Health Care Financing Administration Wants to Make Kidney Transplant Availability Equal, Regardless of Race

Ruth SoRelle, MPH¹

¹ Circulation Newswriter

	Introduction

 
The federal Health Care Financing Administration (HCFA) plans to increase education regarding and the oversight of renal dialysis facilities to ensure that all races, including African-Americans, have the opportunity to be evaluated for kidney transplantation.

Key among the provisions of the program are an effort to communicate with dialysis centers about their responsibility under federal regulations to ensure that all patients in their facility are assessed for possible kidney transplantation and are told whether they are candidates for such a procedure. "Medicare rules require that all patients with kidney failure be evaluated and informed about transplantation," said HCFA administrator Nancy-Ann DeParle. "We want to be sure this is happening and be sure there is equal opportunity for transplantation when needed, regardless of a patient’s race."

The HCFA announcement came in the wake of the publication of an article in the New England Journal of Medicine that found that African-American patients with end-stage renal disease were less likely to want or to be referred for a transplant than their white counterparts (Ayanian JZ, Cleary PD, Weissman JS, Epstein AM. The effect of patients’ preferences on racial differences in access to renal transplantation. N Engl J Med. 1999;341:1661–1669).

The researchers interviewed 1392 patients who ranged in age from 18 to 54 years. Of these patients, 384 were African-American women, 354 were white women, 337 were African-American men, and 317 were white men. They found that 76.3% of African-American women wanted a transplant, whereas 79.3% of white women did, and that 80.1% of . . . [Full Text of this Article]