Racial Inequality in the Living Donor Kidney Transplant Opportunity Structure

Jonathan Daw, University of Colorado at Boulder

Previous research has shown that the very large racial disparities in kidney transplantation outcomes in the U.S. are explained by differential rates of living donor kidney transplants. But what explains these disparities? This paper uses data on the attributes of the kidney transplant waiting list and population data on the distribution of biologically-informed kinship ties and health statuses to investigate the likely distribution of suitable living donors within the kinship networks of persons on the kidney transplant waiting list. The results suggest that black-white disparities in living donor kidney transplantation are not the result of group differences in the availability of suitable donors in their kinship networks. Given the sparse number of potential donors most transplant candidates have evaluated, however, it is likely that the higher probability that white kin are suitable donors is a major determinant of racial differences in living donor kidney transplantation rates.