In 2023, about 36% of Hispanic or Latino candidates waiting for a transplant received one, compared to 58% of non-Hispanic white candidates, according to the US Department of Health and Human Services Office of Minority Health.
Chicago-based Northwestern Memorial Healthcare has improved this disparity with the Northwestern Medicine Hispanic Transplant Program.
The program employs bilingual and culturally sensitive staff and includes education sessions and outreach in order to break down documented barriers to care such as language, lack of knowledge about donation, cultural misconceptions, financial concerns, and distrust in the medical establishment.
“One of the ways that you can break…mistrust is with talking in the native language and explaining that you understand their background, you understand the cultural differences, and that you are going to take the same care that you offer to other patients,” Daniel Borja-Cacho, a transplant surgeon at Northwestern Medicine who has been part of the program since 2018, told Healthcare Brew.
Some people think they’re ineligible for a transplant because they aren’t US citizens or that they “don’t deserve the same care as other races,” Borja-Cacho said.
“Many times during my career, I have heard patients that say, ‘I really didn’t think that I deserved to have a kidney transplant or a liver transplant,’” Borja-Cacho said.
How they did it. Transplant surgeon Juan Carlos Caicedo, who was a kidney transplant surgeon in Colombia before studying at Indiana University and Northwestern, created the program in 2006. At first, it just focused on increasing living kidney donation, Northwestern Medicine spokesperson Erin Haines told Healthcare Brew.
Kidneys are by far the most-needed organ in the US, and Hispanic and Latino populations are at heightened risk of kidney failure and less likely to find a donor or be a donor, the National Kidney Foundation reported last year. Three years after being waitlisted for a kidney, 54% of white candidates had received a transplant compared to about 40% of Hispanic candidates, according to an analysis of 2016–2018 data in the United States Renal Data System 2023 Annual Data Report.
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Northwestern’s program encourages kidney transplant and donation by sending a Hispanic social worker to do outreach at dialysis centers and by providing Hispanic patients and their families with educational sessions that debunk cultural misconceptions, according to a 2015 evaluation.
Prior to this program, Northwestern held educational sessions in English with a Spanish translator available for non-English speakers.
“Even if there’s people that speak Spanish and can translate, there are things that are really hard for the patient to understand if they are not coming from the doctor, from the nurse, directly,” Borja-Cacho said.
A 2015 study found that Northwestern increased its ratio of Hispanic kidney transplant recipients by 70%, from 150 to 255, after beginning this program.
The program has since evolved to include liver, pancreas, and other organs, Haines told Healthcare Brew.
What’s next? Northwestern is further expanding its efforts to decrease transplant disparities at home and across the country. In 2019, the system launched the African American Transplant Access Program.
Other hospital transplant programs nationwide have created kidney transplant programs with staff and education geared toward Hispanic and Latino patients, including Mayo Clinic’s Phoenix, Arizona campus, Tampa General Hospital, the Colorado University School of Medicine, and Murray, Utah-based Intermountain Medical Center.
Systems such as New York University Langone Health and Houston Methodist have established programs focused on increasing liver transplants in this population as well.