The Organ Procurement and Transplantation Network (OPTN) and the United Network for Organ Sharing (UNOS) are implementing new policies to make skin color a crucial factor in who receives life-saving kidney transplants. The shift is perhaps the most dangerous victory for wokeness in health care to date.

In the name of “equity,” UNOS and OPTN purport to be expanding black patients’ access to kidney transplants. They essentially claim that the longstanding system for such transplants is racist, pointing to how black patients make up 30 percent of the dialysis population and transplant wait list but receive a smaller fraction of kidney transplants.

Activists assert that this disparity reflects bias on the part of treating physicians, particularly when referring black patients for early kidney care. But a study from the Veteran’s Administration found that more referrals for expert care did not improve outcomes or prevent progression of advanced kidney disease to the need for kidney replacement therapy.

If racism doesn’t explain the discrepancy, what does? The list of reasons is extensive, reflecting disheartening, stubborn problems that physicians and policymakers have long tried to address. One is the advanced age and complex medical conditions of many black patients with diabetes-related kidney failure; many of these patients are also relatively satisfied with dialysis treatments and unwilling to undergo extensive evaluation for transplant suitability. Others include insufficient health literacy, concern about the surgical procedures associated with transplantation, and lack of a support system for post-operative patients—an especially important factor in transplant suitability. Black families are also less likely to supply kidney donors from relatives.