Equity in Transplant

On December 18^th, KHERG had the unique opportunity to take part in the City-Wide Nephrology Rounds by hosting a presentation on equitable access to living donor kidney transplant. The audience included a range of transplant professionals, researchers, and students in the Toronto area, who were all keen to hear from Transplant Nephrologist, Dr. Istvan Mucsi, and KHERG’s new Research Associate, Lydia-Joi Marshall.

The presentation touched on a range of important topics. Before starting with an overview of the disparities that exist for racialized communities in living donor kidney transplant, Dr. Mucsi made an important acknowledgement of his own biases and the privilege he experiences as a white, male physician. He pointed out how important it is to become aware of your own biases – without doing this, it won’t be possible to empower those who may be disadvantaged by your own privilege.

Following this acknowledgement, Dr. Mucsi presented the trends showing lower access to living donor kidney transplant for racialized communities from published data in Canada, the US, and the UK. While a variety of factors were shown to be partly responsible for causing the lower rates of living donor kidney transplant in racialized communities, it is clear that systemic bias and medical mistrust continue to play an important role in this. Lydia-Joi Marshall pointed out the following steps that healthcare professionals and healthcare systems need to take to improve equitable access to transplant:

• Acknowledge systemic bias and historic mistrust
• Collect and verify “race-based” data
• Increase representation
• Improve communication
• Enhance cultural awareness

After a thought-provoking presentation, the audience was left with the following powerful quote from Peggy McIntosh:

“To redesign social systems we need first to acknowledge their colossal unseen dimensions”

Our newly-funded A.C.T.I.O.N. project will allow us to acknowledge and address many of the unseen dimensions of the healthcare system and is an important step forward in improving equitable access to living donor kidney transplant for the South Asian and African, Caribbean, and Black communities in Canada.