Systematic Review of Disparities in Kidney Transplantation Prior to Implementation of the Kidney Allocation System and Directions for Research.

Major changes were made to the U.S. kidney allocation system (KAS) on December 4, 2014, in the effort to address disparities in kidney transplantation (KT) and achieve equity in organ allocation. Research is necessary to examine whether KAS achieved its goal; first, a firm understanding of the disparities that existed prior to implementation of KAS is needed. This systematic review examined the literature on disparities in access to deceased donor KT (DDKT) after listing in the pre-KAS era and discussed mechanisms to explain these disparities. Thirty-two articles were included. Racial, gender, age, socioeconomic, physiologic, geographic, and health care system disparities existed in the pre-KAS era. Findings of this review will inform the agenda for future disparities research in the post-KAS era.