OPOs are less likely to respond to donation cases involving patients of color versus white patients, and have been shown to spend less time with these families and to provide less compassionate service. This leads to fewer lifesaving organs available for recipients of color - and the COVID-19 pandemic is only exacerbating these disparities.
Likelihood of kidney failure compared to white Americans in the U.S. by race
|Hispanic Americans||Black Americans||Native Americans|
Likelihood to have heptacellular carinoma compared to white Americans in the U.S.
This results from differential OPO practices and resource allocation for communities of color, including that OPOs spend fewer resources on hospital development in communities that serve patients of color, and sometimes even as as the result of specific “guidance by OPOs to not call on specific circumstances to avoid reporting on cases when the OPO believes donation is unlikely [overwhelmingly more commonly for patients of color].”
“One comparison study that looked at differences in organ donor experiences found Black families were “less likely to have spoken to an organ procurement organization representative,” with previous research concluding “[t]he odds that a family of a White patient was approached for donation were nearly twice those for a family of an African American.”
Dr. Ken Moritsugu, Former U.S. Surgeon General: “Often, misallocation of OPO resources means OPOs do not respond to all donation cases, or do not properly train and support their frontline staff. The impact of this, unsurprisingly, falls disproportionately on families of color.”
When OPOs do follow up with the families of patients of color, the quality of the interaction is often inadequate. A study comparing experiences between Black donor families and white donor families found Black people experienced “less complete discussions about the possibility of organ donation.”
Another study found the most common reasons Black families declined to donate were that the OPO did not “give [them] enough time to discuss important issues… or respond to strong emotion with sensitivity and empathy.”
This is a missed opportunity, since families who spend more contact with OPOs are shown to be 3 times as likely to donate.