Black Organ Doners Are Hard To Find
Dr. Dorian Wilson spent a lot of time with physicians as a child — in the emergency room of Jersey City Medical Center. An overactive boy, he often found himself in the ER nursing a broken limb or waiting for stitches.
It was during those visits that he became interested in a medical career, even though as a youth he never believed he’d make it through college, much less become a doctor. “I didn’t think when I was growing up in Jersey City throwing rocks off the 440 bridge that I would be walking in the shoes I am today,” he said.
Not only did Wilson become a doctor and a surgeon, he became a liver transplant specialist at the University of Medicine and Dentistry of New Jersey. He is a Dartmouth graduate with a medical degree from UMDNJ. He is also one of only 19 African-Americans in the nation who are transplant surgeons.
Several weeks ago, 18 members of this elite group met at UMDNJ to discuss their work, encourage minorities to pursue careers in health care and talk about the importance of becoming an organ donor. They were honored by the New Jersey Sharing Network, which brought the doctors together to highlight the importance of organ donation.
Finding African-American organ donors is a critical problem. Nationwide, blacks make up more than 30 percent of all organ donor recipients but only 20 percent of all donors (15 percent in New Jersey). “They have one of the highest needs for transplants but one of the lowest percentage of donors,” said Joseph Roth, president and CEO of the Sharing Network, an organ and tissues service that matches donors to patients. Roth said that only 34 percent of eligible blacks in New Jersey consented to donate their organs, as opposed to 63 percent of eligible whites and 59 percent of eligible Hispanics.
High-profile response Organ donation became headline news when former New Jersey Nets center Alonzo Mourning announced he was retiring from basketball because he needed a kidney transplant. Mourning suffered from focal segmental glomerulosclerosis, a disease that affects the ability of the kidney to remove toxins from blood. Mourning’s plight prompted dozens of fans to offer up their kidneys.
He received a transplant in December from a relative. Race can be an important factor in matching organs, especially for kidneys, Wilson said. Kidneys are the most transplanted organ, and African-Americans like Mourning comprise a third of kidney transplant patients. They also have to wait the longest for an organ.
Blood type is the biggest factor in matching organs, and certain blood types are more common among African-Americans than whites, said Bill Reitsma, director of clinical services for the Sharing Network. For example, only 11 percent of whites have Type B blood, as opposed to 20 percent of African-Americans.
Because there are so few African-American donors, blacks waiting for organs have to wait longer for a match because there are fewer willing donors whose blood type matches theirs. “It compounds their waiting time,” Reitsma said. Nationwide, more than 80,000 are waiting for an organ transplant, half of them minorities. About 17 die each day waiting for an organ.
The disparity between African-American and white organ donation is rooted in the historical distrust of the medical establishment by African-Americans and the disparity in health care between minorities and whites, doctors say. Dr. Devon John, a black surgeon at New York University Medical Center who specializes in transplanting the pancreas, blames the mystique surrounding the process of organ donation.
Many minorities fear that they won’t get the best health care if they sign an organ donor card, or physicians won’t revive them if they are ill because they want their organs, he said. “There’s certainly a lot of distrust and misconception within the African-American community,” John said. A lot of that wariness is the result of the history of discrimination in health care.
In 1932, the U.S. Department of Public Health began the Tuskegee experiment. For 40 years, doctors withheld treatment from more than 600 African-American men suffering from syphilis to study the long-term effects of the disease. Cultural awareness Doctors also say the lack of diversity in the medical field feeds mistrust.
African-Americans make up only 3.75 percent of all doctors in the United States, according to the National Medical Association, an African-American doctor’s group. That figure has not changed in nearly two decades, and many doctors of all races don’t learn how to deal with people from different cultures, John said. “(Doctors) need to be more culturally competent,” said Dr. Charles Modlin Jr., an African-American transplant surgeon at the Cleveland Clinic in Ohio. “There’s a reason for this distrust in the African-American community.”
The overwhelmingly white medical field is also a difficult terrain for black medical students to navigate, the doctors said. Many of the African-American surgeons at the meeting said they believe that the way to help black patients is to combine the appeal for donors with education about living healthy lives and getting regular examinations from doctors.
Blacks are nearly twice as likely as whites to suffer from diabetes and hypertension, which can lead to the need for an organ transplant if not properly treated. Blacks make up 40 percent of all cases of renal failure in the United States, the leading cause of kidney transplants, but in 2003 received only about 20 percent of all available kidneys, while whites received 64 percent. Whites are also more likely to get a kidney from a living donor or a relative. Hispanics received about 12 percent.
“Our patients often don’t link up with a primary care physician” to get proper preventive care, said Dr. David Kountz, an associate professor and general practitioner at UMDNJ. Internists can spot the need for a transplant early and find a donor, he said. His father, Dr. Samuel Lee Kountz, was the first African-American transplant surgeon.
Wilson said it is important for everyone to let family members know their wishes about organ donation. This will make it easier for them to choose whether to donate a loved one’s organ if that time ever comes.
“This is a terribly, terribly important responsibility,” Wilson said. “This is a responsibility we all share regardless of your age, the color of your skin or the place where you were born.”
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