Study: Correcting the Discrepancy Among Races and Live Kidney Transplants

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Naoru Koizumi: NSF study aims to correct racial disparity in access to live-donor kidney transplants.

“Life after a kidney transplant is so much better than being on dialysis,” said Naoru Koizumi, a professor and the associate dean of research at the Schar School of Policy and Government. “But minority patients—particularly black Americans—don’t have equal access to transplants.”

It is also crucial, she added, that transplanted kidneys come from living donors, where there is survival time of over 15 years. Kidneys from living donors add 5 to 7 years with a higher quality of life to the recipient.

“That’s why we want to give living donor transplants to as many patients as possible,” said Koizumi. “African Americans are particularly the ones that don't get to be on a transplant list.”

Minorities are at a disadvantage when it comes to live kidney access for many reasons, including cost, insurance, and location. Where you live is an important factor as to when and what type of kidney transplant is available—and traveling great distances to be higher on a waiting list of recipients can be cost prohibitive, particularly for those living in underserved regions.

Working with transplant programs at George Washington University and Virginia Commonwealth University, Koizumi leads a George Mason University-led team hoping to create an algorithm to identify the optimal ways to increase live donor transplant access for minority patients, particularly those from low socioeconomic black communities.

In other words, Koizumi leads a team of medical and data researchers to correct the racial discrepancy of live kidney transplants.

The three-year study, Collaborative Research: SCH: Optimal Desensitization Protocol in Support of a Kidney Paired Donation (KPD) System,is funded by the National Science Foundation. Koizumi serves as the principal investigator overseeing the $996,766 grant, $677,361 of which funds Mason’s involvement.

Joining Koizumi are Professor Chun-Hung Chen and Assistant Professor Hadi El-Amine from Mason’s Volgenau School of Engineering. Both teach systems engineering and operations research. Researchers at the University of Maryland and the University of Louisville are also contributing to the study.

For Koizumi, the topic of organ transplants has interested her since early 2000, when she was studying for her first doctoral degree at the University of Pennsylvania, focusing on geographic disparity in health care access. But it was while earning her second doctorate in environmental and preventative medicine at Japan’s Hyogo College of Medicine studying end-stage renal and liver diseases that she encountered the issue of race and class among kidney transplants in the U.S.

During that time, Koizumi met two kidney surgeons, both of them black, at the George Washington University Hospital Transplant Institute and Howard University “who taught me a lot about racism in medicine and their own personal discrimination experiences during medical training,” she said: GWU’s Joseph Keith Melancon and Howard’s Clive O. Callender, last year’s Pioneer Award recipient from the American Society of Transplant Surgeons and the first black transplant surgeon in the U.S.

They became mentors who “taught me a lot about the racial disparity in access to kidney transplants.”

Once the study is complete in 2025, programs can be designed locally—Koizumi is working with patients in Washington, D.C.’s Wards 6 and 7—and then nationally by promoting kidney-paired donation (KPD), which allows “donor swapping” among incompatible donor-patient pairs in the Washington, D.C., region.

International impact, she said, “is not out of the question. There’s a lot of potential in that.”