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Patient sues Cedars-Sinai and UNOS, says racially biased AI made him wait longer for a kidney

por John R. Fischer, Senior Reporter | April 14, 2023
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A Los Angeles barber waiting five years for a kidney transplant says a racially biased algorithm used by UNOS and Cedars-Sinai prevented him from getting one sooner. (Photo courtesy of Cedars-Sinai)
A Los Angeles man waiting five years for a kidney is suing a subsidiary of Cedars-Sinai and the United Network for Organ Sharing (UNOS), a nonprofit that manages the Organ Procurement and Transplantation Network, alleging that their use of a racially biased algorithm prevented him and other Black patients from getting the organs they need sooner rather than later.

In June 2022, UNOS included a “modifier for patients identified as Black” that showed that part of the algorithm used to prioritize transplants underestimated the severity of kidney disease in many of these patients, leading it in January to instruct hospitals to no longer use the problematic part and inform Black patients that their “accrued wait time” may be adjusted.

Assigned waiting times are necessary for determining the order of potential kidney recipients, since donations are in short supply, along with other organs. But despite end-stage renal disease being three times more common in Blacks than white patients, Black people are much less likely to receive a kidney or even be put on the transplant waiting list, reported the Washington Post.

“Specifically in organ transplantation, it may have negatively affected the timing of transplant listing or the date at which candidates qualify to begin waiting time for a transplant,” said the UNOS board of directors.

Anthony Randall is asking a federal court to make his lawsuit a class action on behalf of 27,500 Black patients on the grounds that they may have been subjected to longer waiting times than necessary. He says that his own kidney disease has prevented him from working as a barber and required him to undergo dialysis three times a week.

While Cedars-Sinai began complying with the UNOS directive on March 27, the review of cases will take months, according to Randall’s suit, which says that as of April 5, his “wait time continues to be incorrectly calculated in UNOS’ UNet software.”

It goes on to say that the racial discrimination here has “damaged [the] plaintiff and members of the nationwide waitlist class, the California waitlist class, and the Cedars-Sinai class,” according to the Post.

Over 104,000 people are on the transplant recipients waiting list, with most in need of a kidney. About 17 to 33 patients die daily waiting for a kidney, liver, lung, heart, and other organs.

UNOS, which declined the Post’s request for comment, came under fire in August when a three-year Senate committee report showed that errors in organ screening for transplant recipients nationwide resulted in 70 unnecessary deaths and 249 illnesses.

In response, the U.S. government said in March that it would expand the number of eligible competitors for overseeing the Organ Procurement and Transplantation Network, and would integrate more transparency and accountability into the network’s processes.

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