Equity in Kidney Transplantation (EqKT) Initiative

Bringing the kidney transplant evaluation program to the Black, Indigenous, and LatinX communities

Providing culturally competent training and education to the clinical care teams, patients, and loved ones in minority communities about transplantation and living donation

Supporting patients through a complex and long process with care and resource coordination

Evidence-based behavioral coaching and rapport-building to increase compliance and stamina for a (sometimes) long transplant journey

Collecting and analyzing data around social determinants of health, health-related social needs, and how they may impact patient outcomes throughout all stages of the transplant process—from referral to after transplantation

Training internal teams to ensure quality, safe, and culturally competent care

Download a PDF of the Kidney Transplant Program Roadmap

The EqKT Initiative was originally created to address disparities in access to kidney transplantation among racial and ethnic minorities. Black, LatinX, and Indigenous communities experience much higher rates of end-stage kidney disease compared to white populations, yet they often encounter barriers to receiving care.

Over time, our program has evolved to optimize clinical care for all individuals, regardless of racial, ethnic, or social factors that may limit access to transplantation. These health disparities often extend beyond medical issues to include social determinants of health, such as income, education, housing, and systemic inequities.

We aim to reduce these disparities by bringing our evaluation programs into local communities and more.

The EqKT clinical team includes English- and Spanish-speaking providers. At Mass General, we offer additional resources, including nationally trained and certified medical interpreters to support individuals and families who are Limited English Proficient or Deaf and Hard of Hearing. We provide access to over 200 languages through Medical Interpreter Services.

The eGFR is a number calculated based on the blood test for creatinine. It tells how well the kidneys are working and, in addition to creatinine levels, it takes into account the patient’s age, sex, and sometimes race. Factoring in race results in a higher eGFR for Black patients, putting them at a disadvantage because a higher GFR means better kidney function. This flawed equation can have negative implications in a patient’s access to therapy.

The Kidney Transplant Program at Mass General has an expedited listing process, allowing patients to be listed on the United Network for Organ Sharing (UNOS) deceased donor waitlist after initial evaluation with minimal testing. As a listed patient accrues more waiting time and nears the top of the waitlist, they enter the Readiness Phase (12- to 18-months before an organ offer is expected). Through care coordination and communication, we ensure the patient is ready to receive a kidney offer. The patient must be in good health, maintain healthy habits and weight, and be up to date on required vaccinations, health screenings and tests. It is during the Readiness Phase that all required lab and imaging tests are completed. This expedited process means the patient can start accruing time on the UNOS waitlist sooner, while the Readiness Phase cuts down on the patient’s need to repeat tests and screenings that may expire while waiting. Download an overview of the patient’s journey through the Mass General Kidney Translant Program.

The best option is to receive a kidney from a living donor, as this does not require time on the waiting list and reduces the need for dialysis (among other benefits). Patients often identify a living donor in their own life who is willing to donate their kidney directly to them. We also work closely with paired-exchange program(s) to assist patient-living donor pairs that are incompatible. In this program, the living donor will donate their kidney to an unknown, compatible recipient. Then, the patient will receive a kidney from an unknown, compatible donor as part of a swap.

Patients without a living donor wait on the UNOS list for a deceased donor kidney.

The Mass General transplant team will assist patients with navigating the living and deceased donor processes through Donor Champion education and other resources. Download an overview of a prospective donor’s journey through the Mass General Kidney Donor Program.

Our community evaluation locations are solely dedicated to pre-kidney transplant evaluation. You can expect to receive evaluation and any necessary initial testing at the evaluation program. Once in the readiness phase, you will be informed of next steps and necessary testing to prepare for transplant. The surgery will take place at Mass General at 55 Fruit Street, Boston, MA 02114. Following the surgery, you can receive post-transplant care at either:

• 165 Cambridge Street, Boston, MA 02114
• 102-104 Endicott Street, Danvers, MA 01923

Yes, the Mass General EqKT Initiative is designed to serve all historically disadvantaged patients regardless of residence in or proximity to Chelsea, MA, or Boston, MA. Depending on access, patient needs and preferences, our equitable English- and Spanish-speaking team can be deployed to conduct portions of the pre-kidney transplant evaluation in a nearby community location that is more convenient for you (Danvers, MA, Northampton, MA, and Portsmouth, NH). However, some portions of the evaluation may only be available at our full-service locations in Chelsea and Boston, MA. Please call our team at 877-644-2860 for more information about our services.