*Purpose: Although minorities are the majorities in the kidney transplant waiting list, it is unknown if kidney transplant programs in United States have implemented linguistically and culturally sensitive initiatives to decrease disparities in kidney donation and transplantation in minorities.

Our aims were : 1- To determine any evidence of culturally and linguistically sensitive initiatives amongst kidney transplant programs in the United States and its progress over the last five years. 2- To determine if would be feasible to increase number of culturally and linguistically sensitive initiatives based on the diversity of the transplant work force.

*Methods: Data was obtained from the websites of 240 transplant centers in 2013 and 244 centers in 2018. Websites with incomplete information about their nephrology or surgical teams were excluded from analysis, resulting in a total of 174 evaluable sites in 2013 and 185 sites in 2018.

*Results: We included data from 1,312 and 1,457 transplant physicians in 2013 and 2018, respectively. There was no significant change in the proportion of minority transplant surgeons: African Americans (5.5% vs 4.1%; p = 0.23) and Hispanics (8% vs 6.4%; p = 0.26). Similar results were observed with the proportion of minority transplant nephrologists: African Americans (3.3% vs 2.3%; p = 0.24) and Hispanics (7.9% vs 5.5%; p = 0.07). Only 54 (31.0%) centers in 2013 has a transplant physician who spoke a language other than English, yet this number more than doubled to 143 (77.3%) in 2018 (p <0.001), with 71 centers (38.4%) having at least one transplant physician who spoke Spanish. Very few websites provided information in a language other than English (11 (6.3%) in 2013 and 18 (9.7%) in 2018; p = 0.24). Only 3 websites (1.3%) in 2013 and 9 (4.9%) in 2018 reported having any evidence of a culturally-tailored initiative (p = 0.05).

*Conclusions: Despite minorities are the majorities on the kidney transplant waiting list and are expected to significantly grow in the U.S., transplant centers have made very small progress in implementing culturally-tailored initiatives that could potentially reduce disparities in transplant access, living donation and kidney transplantation. It seems feasible to increase number of culturally and linguistically sensitive initiatives based on the diversity of the transplant work force at least to match its proportion.

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