Why donors of color are urgently needed

Black patients face the largest match gap in the US registry, with published estimates of finding a fully matched unrelated donor around 30 percent or lower. The cause is the shortfall of donors of African ancestry on the registry, not anything about the patients themselves.

Sickle cell disease also disproportionately affects Black Americans, and a bone marrow transplant is one of the few potentially curative options for severe disease, though it is a serious treatment decision made by a patient’s clinical team. The National Heart, Lung, and Blood Institute describes the condition and its treatment.

National registries run community-specific recruitment efforts for African American donors, and faith-community drives and drives at historically Black colleges and universities (HBCUs) have long been significant channels. Registration through any national registry counts toward closing the gap.

Hispanic and Latino patients find a fully matched donor at a rate well below that of white patients. The broad category also hides wide variation: people of Mexican, Puerto Rican, Cuban, Dominican, and Salvadoran heritage, among others, carry distinct HLA distributions, so a patient of Puerto Rican heritage benefits most from donors of Puerto Rican heritage specifically.

The Icla da Silva Foundation, the largest Hispanic-focused recruitment organization in the US registry network, has long run community drives at cultural organizations, churches, and Latino-focused workplaces. Registration through any national registry adds to the same pool.

Asian American and Pacific Islander (AAPI) patients also find matches at lower rates than white patients. The AAPI category spans East Asian, Southeast Asian, South Asian, and Pacific Islander populations, each with distinct HLA distributions, and Pacific Islander representation on the registry is especially low.

The Asian American Donor Program (AADP) has long run recruitment across these communities, with college AAPI organizations, cultural associations, and faith communities serving as frequent drive hosts. Registration through any national registry counts.

Multiracial patients face the hardest match scenario in the dataset, because an HLA profile drawn from more than one population is rare in any single population’s pool. For the same reason, multiracial donors are especially valuable: one profile may match across several populations.

Multiracial people are also among the fastest-growing groups in the US, and registry representation has not kept pace. Registering as a multiracial donor measurably benefits future multiracial patients who would otherwise have very few options.

Indigenous and Native communities are severely underrepresented on the registry. The terms are related but distinct: Native American refers to the Indigenous peoples of the continental US, Indigenous is a global category, and Native Hawaiian and Alaska Native are separate groups often counted under the Indigenous heading in US data.

Because the registry holds so few donors from these communities, patients have among the fewest matched-donor options of any group. Recruitment happens through tribal communities, urban Native organizations, and Native student associations at colleges. Registration through any national registry counts toward closing that gap.