Academics have found that some children in need of a kidney transplant are facing inequalities in their care.
Researchers set out to examine whether inequalities exist in access to kidney transplantation among children in the UK by analysing the UK Renal Registry and NHS Blood and Transplant data between 1996 and 2020.
The team at the University of Bristol found that Black children were less likely to be put on the transplant waiting list, as were those from more deprived backgrounds.
Girls were also 12 per cent less likely to be put on a transplant waiting list compared to boys.
There are currently 137 children aged 17 and under on the kidney transplant waiting list in the UK.
Dr Alice James, lead author of the study, said the gender disparity in wait-listing may reflect “implicit gender biases in clinical decision-making, differences in parental advocacy, or variation in disease presentation and severity between sexes.”
“There may also be social factors influencing clinicians’ assumptions about transplant suitability or family engagement in the transplantation process,” she said.
“While evidence is limited in paediatric populations, adult studies suggest that women are often perceived as less suitable candidates due to comorbidities or psychosocial factors— perceptions that may inadvertently extend to female children.”
It also found that children from the poorest backgrounds were 33 per cent less likely to be put on the waiting list compared to those from the wealthiest, and Black children were 19 per cent less likely to be put on the waiting list compared to their white peers.
Once children are on the waiting list, the disparities related to gender and income appeared to reduce, however, disadvantages for black children persisted.
“We were particularly struck by how early these disparities appear in the transplant process,” Dr James said.
“It’s not just about who gets a transplant, but who even gets considered in the first place.
“Those from black ethnic backgrounds face systemic disadvantages even after being placed on the waitlist, including fewer living donor opportunities.”
When looking at kidney transplants given by a living donor within two years of being on the waiting list, the odds of getting a transplant are lower among those from poorer backgrounds and children of black or Asian ethnicity, according to the study, which has been presented to the ESOT (European Society for Organ Transplantation) Congress 2025.
Dr James added: “It is notable – and particularly disquieting – that such disparities are evident even in a paediatric population within a universal healthcare system like the NHS.
“The persistent disadvantage faced by children from black ethnic backgrounds even after wait-listing is especially striking, suggesting systemic or cultural barriers that extend beyond access alone.”
Fiona Loud, policy director at Kidney Care UK, said the research was “shocking”.
“More work needs to be done to explore local barriers and raise awareness of the value and importance of living kidney donation through personalised and community education programmes.”
Professor Derek Manas, medical director for organ and tissue donation at NHS Blood and Transplant, which is responsible for allocating organs to people on the list, said: “These results will help hospital clinical teams across the UK to further understand and mitigate this issue.
“NHS Blood and Transplant does not decide which individual patients are added to the transplant waiting list, but we do manage how organs are allocated to patients, and the research found that once patients are on the waiting list, they had equitable access to donations, irrespective of ethnicity or deprivation.
“The transplant community has come a long way in ensuring equity once listed, but this study confirms we all have more to do.
“Kidneys also need to be matched and people from the same ethnicity are more likely to be a match.
“There are currently not enough donors from black and Asian backgrounds and we urge people to show their support for donation on the NHS Organ Donor Register and to tell their families they want to donate.”
Girls and black children face inequalities in transplant treatment, study shows
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