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New Transplant Waitlist Policy Would Distribute Human Organs Based on “Equity”


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A report commissioned by UNOS envisions a drastic reduction in prioritization for living donors — going from the current virtual guarantee of getting a new kidney to a slight bonus on the waiting list — equivalent to as low as 10 percent of the total prioritization score. This policy would betray those who have already donated an organ and discourage others from donating in the future. They are pushing this policy even though their own research shows that changing from the current policy will not reduce death rates but lead to a higher rate of failed kidney transplants in the first year after surgery.

Why is UNOS doing this? They cite values such as transparency and equity. Often when people say a policy change is motivated by “equity,” everybody knows exactly what equity means. But for this policy, nobody knows what it means.

This new policy constantly refers to “improvements in equity,” but it’s not clear in what context. You might reasonably guess that this policy is meant to help black patients or other minorities, but the research commissioned to support this policy change shows that transplant rates by race and ethnicity will barely change.

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