Of kin and kidneys: Do kinship networks contribute to racial disparities in living donor kidney transplantation?

Abstract

In the United States, racial disparities in kidney transplantation are large and especially stark for living donor transplants. Medical researchers frequently attribute this to the availability of medically compatible living kidney donors, who are usually kin. This paper evaluates this hypothesis by testing whether African American transplant candidates likely have lesser access to suitable living donors in their kinship networks than white candidates. This paper evaluates this hypothesis using a simulation design. Contrary to prior research on this topic, this simulation analysis concludes that black-white disparities in living donor kidney transplantation are unlikely to be the result of group differences in the availability of suitable donors. Although individual white kin are individually more likely to be suitable donors, African Americans' larger average kinship networks compensate for this difference.