The risk of developing end-stage renal disease is four times higher in the Black than in the White population. The number of Blacks on dialysis or on the waiting list for transplantation continues to grow due to an insufficient number of suitable organ donors. Same-race transplants have been shown to be more successful when blood types and human leucocyte antigens are used as the matching criteria. The low levels of organ donation by Blacks has been attributed to a number of factors. This article reviews some of the more complex factors (e.g., social practices, religious beliefs, and cultural expectations) affecting the organ donation decision. In addition, some implications and strategies are suggested that may increase the rate of organ donation in the Black community.
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