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Advancing Altruism

National Minority Organ and Tissue Transplant Education Program Joins GW to Raise Organ Donation Awareness

By Steve Goldstein

According to the U.S. Department of Health and Human Services, 34 percent of the more than 101,000 people on the national waiting list for a kidney transplant are African-American. Overall, minorities account for 58 percent of those on organ transplant lists, but represent just 42 percent of those who receive transplant surgery. African-Americans make up the largest group of minorities in need of a transplant, at 30 percent, but they make up less than 14 percent of donors. Due to the greater incidence of diabetes and high blood pressure among African-Americans, they are more at risk for organ failure. Organ types are more likely to match if they come from individuals of the same ethnicity.

Community education is vital in reducing the rate and number of ethnic minority Americans in need of organ and tissue transplants. It’s a big part of why, when J. Keith Melancon, M.D., came to Foggy Bottom in the fall of 2014 to serve as professor of surgery at GW’s School of Medicine and Health Sciences (SMHS), chief of the Division of Transplant Surgery, and director of the Transplant Institute at GW Hospital, he brought with him a ready-made community health organization, the National Minority Organ and Tissue Transplant Education Program (MOTTEP®). The partnership is the realization of Melancon’s vision of increasing kidney donations by raising awareness. MOTTEP’s expertise in the community helped garner support among District of Columbia authorities for the new transplant center.

“MOTTEP is a grassroots community organization,” explains Melancon. “What it has done for GW is identify the best access for us to reach the people with end-stage renal disease.” Hospitals, he adds, traditionally don’t know where to go to interact with the community for health interdiction. “MOTTEP knows the corporate structure that’s interested in helping, as well as where citizens tend to congregate and are open to this kind of discourse about health.”

At a recent community event at a local Safeway grocery store, scores of D.C. residents received blood pressure tests, cholesterol checks, weight measurements, body mass assessments, and other health tests. They were also encouraged to sign organ donor cards. “There’s been a long-standing suspicion in the African-American community about transplants and the medical establishment,” says Melancon. “MOTTEP is educating people so that they understand that if they donate more, there will be more transplants… . We’ve done numerous events with MOTTEP, and they’ve been very successful.”

Clive Callender, M.D., who established MOTTEP in 1991, believes Melancon’s efforts are crucial to the organization’s mission and success. “Keith is a tremendous transplant surgeon,” Callender says, “but what’s special about him is his real love for the community and his willingness to go into the community to educate and empower people. He understands communication, and he has charisma, which makes him effective at reaching all ethnicities.”

MOTTEP, Callender explains, has created community programs for building relationships and raising community awareness regarding organ transplant in minority populations in the Washington, D.C. area. MOTTEP also promotes healthy lifestyles to prevent kidney disease.
Callender’s strategy to educate and raise awareness about the need for organ and tissue donation was based on overcoming five obstacles identified through focus groups:

  • Lack of community awareness about renal disease and transplantation
  • Conflicting religious beliefs
  • Distrust of the medical community
  • Fear that signing an organ donor card meant medical personnel would not work as hard to save them
  • Belief that their organs would go only to whites

“We have always focused on outcomes,” says Callender, a clinical professor of surgery at Howard University Hospital, where he began a local MOTTEP in 1978 with a $500 grant from the D.C. government to investigate low donor rates among minorities. “Of course, we wanted attitudes toward donation to change. But the important thing was to change behavior, and we have seen donations from blacks more than double since we started.”

MOTTEP joined with GW Hospital in its application to initiate a kidney and transplant program, and a certificate of need was granted in February 2014. A contract with MOTTEP was signed that same year and runs through 2017. MOTTEP’s presence at GW includes program director Patrice Miles, an administrator, and a regional coordinator.

“When I started MOTTEP, many people told me one person couldn’t change the donation equation for minorities,” says Callender, who, in New York City’s Harlem neighborhood, contracted tuberculosis at age 15 and was hospitalized for more than a year and a half. “My own adversity — and telling me it couldn’t be done — inspired me to do what seemed impossible.”