Equity in Kidney Transplantation (EqKT) Initiative
Massachusetts General Hospital | Transplant Center
165 Cambridge Street, Suite 301
Boston, MA 02114
Other Kidney Transplant Evaluation Locations
Massachusetts General Hospital—Chelsea Healthcare Center
100 Everett Avenue
Chelsea, MA 02150
Mass General Brigham—Wentworth-Douglass Hospital (Pease)
121 Corporate Drive, Building A
Portsmouth, NH 03801
Massachusetts General Hospital/North Shore Medical Center
102-104 Endicott Street
Danvers, MA 01923
Massachusetts General Hospital—Cooley Dickinson Hospital
30 Locust Street
Northampton, MA 01060
Explore This Program
About the Equity in Kidney Transplantation (EqKT) Initiative
Black, Indigenous, and LatinX communities are disproportionately impacted by end-stage kidney disease (ESKD), a permanent form of kidney damage that occurs as a result of chronic kidney disease. Kidney transplantation is considered the best therapy for ESKD, providing increased survival rates and improved quality of life, but it is often less accessible to patients of color.
Addressing Racial Disparities with Kidney Transplantation Accessibility
In partnership with the Massachusetts General Hospital Center for Community Health Improvement, Mass General Transplant Center is committed to addressing racial disparities in kidney transplantation through its MGH Equity in Kidney Transplantation (EqKT) Initiative. Unlike the traditional team model, the EqKT initiative deploys a core team consisting of a transplant nephrologist, nurse coordinator, social worker, and health and wellness navigator to conduct evaluations within the community. Our health and wellness navigator is instrumental in ensuring equitable access to transplant care, helping to increase the number of minority patients who are waitlisted and transplanted at Mass General every year.
Care in the community
- 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
Care and resource navigation
- 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
Equitable Kidney Transplant Evaluation in the Community
The Mass General EqKT Evaluation Program brings equitable kidney transplant care directly to the community. We provide full pre-kidney transplant evaluation at the MGH Chelsea HealthCare Center in Chelsea, MA. Patients from both Chelsea and other nearby communities can come to be evaluated for a kidney transplant by an English- and Spanish-speaking Mass General care team that works closely with local providers.
The MGH EqKT Initiative is designed to serve all historically disadvantaged patients regardless of residence in or proximity to Chelsea or Boston. Depending on access, patient needs and preferences, the EqKT clinical team can also conduct virtual evaluations or be deployed to other community locations. However, some portions of the evaluation may only be available at our full-service locations in Chelsea and Boston, MA.
How to Make an Appointment for Pre-Kidney Transplantation Evaluation
Patients can request an appointment themselves or be referred by their doctor.
The minimum requirement to request an appointment or submit a referral for evaluation is for patients with a glomerular filtration rate (GFR) of </= 25. Mass General does not use race as a criteria when calculating a patient’s eGFR. Patients are encouraged to speak with their primary care providers to ensure race was not factored into their eGFR, if calculated outside of Mass General.
Our Core Clinical Team
Our Leadership Team
- Surgical Director, Kidney Transplantation
- Chair of Quality Improvement, Transplant Center
- Associate Director, Mass General Transplant Center
- Director, Transplant Infectious Diseases and Compromised Host Program
- Harold and Ellen Danser Endowed Chair in Transplantation
- Medical Director of Kidney Transplantation
- Department of Medicine
- Administrative Manager
- Program Manager
Frequently Asked Questions
What does the road to transplantation at MGH look like?
Why is this evaluation program dedicated to minority patients?
There is a significant disparity in access to renal transplant care for Black and LatinX patients in New England, communities that experience end-stage kidney disease at a four- and two-times higher rate than their white counterparts, respectively. We are working to reduce this disparity in collaboration with the MGH Chelsea HealthCare Center by bringing an evaluation program operated by English- and Spanish-speaking providers to a community-based location.
What is the estimated glomerular filtration rate (eGFR)?
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.
How does Mass General's expedited listing process and transplant readiness work?
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.
What are my options for receiving a kidney?
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.
Can I receive surgery or post-transplant care at the community-based evaluation programs?
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