Black and Hispanic patients are disproportionately more likely to experience kidney failure and other conditions that cause them to need a transplant, yet they are less likely to become organ donors.
dr. Michael Moncure, md
As a trauma surgeon, I’ve spent decades witnessing the life-changing impact of organ donation—both on the recipients who gain a second chance at life and the donor families who find solace in their generosity during times of unimaginable grief. This saves tens of thousands of patients every year. Yet, there remains a critical shortage of organ donors, particularly among Black, Hispanic, Native American, Asian and Pacific Islander communities. This is driven by historical mistrust and systemic inequities in U.S. health care. We must prioritize diversity and transparency in donation to earn the trust of patients and their families.
I received my medical degree at the University of Washington, though my journey into organ donation advocacy truly began during my residency at Howard University. There, I trained under the mentorship of Dr. Clive O. Callender, a pioneer in organ transplantation and patient advocacy. I’m proud to have been involved in the early days of the National Minority Organ Tissue Transplant Education Program (MOTTEP), which Dr. Callender launched. It is the first national organization dedicated to ending the organ donor shortage by expanding outreach and education to increase the number of donors from all backgrounds. Dr. Callender’s approach was groundbreaking then and remains essential today as diverse communities, especially Black Americans, continue to be overrepresented on transplant waiting lists.
Here in Kansas City, all organ and tissue donations are managed by Midwest Transplant Network, a nonprofit organ procurement organization where I have served in multiple capacities, including medical director, for over 20 years and counting. Its staff carry the responsibility and privilege of identifying donors who pass away at hospitals, recovering their organs and transporting them to matched patients in time to save their lives. They do this every hour of every day. They also support donor families, raise awareness in the community, and help people register as donors.
Black and Hispanic patients are disproportionately more likely to experience kidney failure and other conditions that cause them to need a transplant, yet they are less likely to become organ donors. This is not due to a lack of willingness to help others but often because of a deep-seated mistrust of the health care system—a mistrust that is fueled by both historical injustices and current perceptions of bias within health care.
The truth is that medical professionals do everything they can to save a patient’s life and will never consider his or her organ donor status until every other option has been exhausted. At the same time, transplant patients are prioritized based only on medical urgency and geographic distance. The transplant system is fair and equitable, but to convince people of that, doctors like me have to be more transparent about the process. When donors and their families are fully informed and involved, they see that they and their loved ones will be treated with the utmost care and respect.
I have seen firsthand how transparency can build trust. Once, a patient was brought to my hospital with severe brain injuries. I invited the family to witness our entire neurological exam, which showed the patient was not breathing independently. They understood the reality of the patient’s condition and, knowing we did all we could to save that life, made the courageous decision to donate. They thanked me for being open, and in their darkest hour, they found a small measure of peace knowing their loved one’s final act was one of giving.
The decision to become an organ donor transcends race, religion, income and all other statuses. I have seen families from all walks of life find connection through this shared experience – white families embracing Black recipients of their loved ones’ organs and vice versa. To them, the only thing that matters is the donor’s gift of life that brought them together.
Organ donation is the one area in health care in which one person’s decision can directly save lives. For this reason, we must continue to advocate for diversity, transparency, and trust within our communities. By doing so, we not only honor the legacies of those we have lost, but also ensure that – one day – nobody will have to die waiting for a transplant. The more voices we have in this conversation, the more lives we can save.
Every donor can save up to eight lives through organ donation and heal over 100 more through tissue and eye donation. Please visit www.mwtn.org/share-life-midwest to learn more about donation and how to register.
Michael Moncure, MD is a trauma and critical care surgeon at University Health in Kansas City and serves as Administrative Medical Director for Midwest Transplant Network, the nonprofit organ procurement organization (OPO) serving Kansas and the western two-thirds of Missouri since 1973.