Ethnic Minority Organ Donors
The NHS says there’s an “urgent need” for more people from ethnic minorities to become organ donors. In the NHS Blood and Transplant report published today shows that ethnic minorities wait significantly longer for organ transplants.
Kidney Donors
The majority of people waiting for an organ on waiting lists are waiting for a kidney donor. These are particularly hard to source as successful kidney transplants require both blood and tissue type matches whereas other organs can be transplanted on a blood type match alone.
According to the report waiting time for kidney donation averages 488 days for white people, 650 for Asian people and 735 days for black people.
“Black people wait longer because there’s less people coming forward to give their organs from their ethnic group”
Winnie Andango, Equality, Diversity and Inclusion Lead at NHS Blood and Transplant
“During covid, so many patients were suspended but those have been added back onto the list, and that means if we had less organs for this ethnic minority group we have even less right now.”
Opt out transplants
These ongoing disparities are despite the law on organ donation changing in England in 2020 to an opt-out rather than an opt-in system. Similar changes were made in Scotland in 2021, Wales has had opt-out organ donations since 2015.
There are reasons, cultural and religious, including a low level of trust in the system and a lack of understanding that ethnic minorities are subject to extra long wait times that hold back ethnic minority family consent and donation rates.
Black people in particular are more likely to suffer from high blood pressure, diabetes and some forms of hepatitis than white people. These conditions each make it more likely that they will require a transplant over their lifetime.
Belinda Otas, 43, from London is currently waiting on dialysis for her third kidney transplant after becoming ill when she was just 15 years old. After two previous transplants which both eventually led to rejection, Belinda has waited almost five years for another chance.
Belinda explains “Living on dialysis is like living in limbo, you cannot plan and it defines your whole life. My first kidney transplant changed my life; I was free from dialysis and felt I was given a second chance. I could study again and at the age of 25 I began a degree at university. I was also given the freedom to live, travel, have adventures, to plan and have the chance to visit family in Nigeria. I missed them so much when I was on dialysis.
“We need more people, especially those from black and Asian heritage, to register their organ donation decision and share it with their family so loved ones can follow their wishes.”
Health Minister Neil O’Brien
Ongoing disruption caused by the pandemic has also held back the number of transplants performed with 2022 rates of organ donation still lower than 2019.
Final thought
Ongoing disparity in service between ethnicities is obviously unfair but as ever the causes are complicated. In this case black people are more likely to need transplants which comes both from lifestyle differences and racial variation in illness prevalence. At the same time they are less likely to donate. Several religions such as Islam and Jehovah’s Witnesses are both more prevalent among ethnic minorities and have taboos against organ transplants or blood transfusion.
The result of these factors is that black people can wait 50% longer to receive a transplant than white people with all the increased danger of death and complication that entails.
Any solution to these complicated problems will be similarly multifaceted. Campaigns to raise awareness among ethnic minorities such as BBC Radio DJ Ace’s will be needed to promote opt-in or at least a lack of opt-outs among ethnic minorities. Ethnic disparities in health outcomes will have to be driven down more generally, first before people get sick and then within the health service to reduce demand. Finally, experts in religion will need to explain religious doctrine to patients to ensure they are making informed decisions.
Sadly, it seems that opt out organ donation has not been a cure-all for the UK’s organ shortage and the long waiting lists for people awaiting transplant. Further reform will be needed.