Ms Katie Cundale1,3, Professor Stephen McDonald2,3,4, Ms Kelli Karrikarringka Owen1,4, Professor Jaquelyne Hughes5
1South Australian Health and Medical Research Institute, Adelaide, Australia, 2Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), Adelaide, Australia, 3Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, Australia, 4Central Northern Adelaide Renal & Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, Australia, 5Rural and Remote Health, Flinders University, Darwin, Australia
Biography:
Professor Stephen McDonald, AM is a Senior Staff Nephrologist at the Royal Adelaide Hopsital, Executive Director of the ANZDATA Registry, and Co-Chair of the NIKTT. His work focuses on data-driven improvements in dialysis and transplantation care across Australia, especially for Aboriginal and Torres Strait Islander people.
Professor Jaquelyne Hughes is a Torres Strait Islander (Wagadagam Tribe) nephrologist, leading clinician-researcher and Co-Chair of the NIKTT. She advocates for health equity and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples in the Torres Strait and across Australia.
Aim:
The National Indigenous Kidney Transplantation Taskforce (NIKTT) aims to execute a Community-owned vision of culturally safe practice within Australian transplantation care.
Background:
NIKTT was established as a time-limited initiative to address longstanding inequities in kidney transplantation access for Aboriginal and Torres Strait Islander peoples. These inequities persist despite the efforts of many clinicians, reflecting deeper systemic barriers within practice and policy.
Methods:
NIKTT’s work is anchored in First Nations governance, lived experience, and co-design. Since 2018, the NIKTT has driven a Community-led change agenda by funding pilot projects across four jurisdictions, supporting the establishment of Indigenous Reference Groups, consulting with Aboriginal and Torres Strait Islander communities across the care pathway, and maintaining strong engagement with clinicians, policymakers, and service providers. This work has prioritised action through advocacy, grounded in Community priorities and informed by lived and clinical expertise.
Results:
Seven years of sustained operations have resulted in a Community-confirmed movement for change across jurisdictions. NIKTT has delivered three national Gatherings, coordinated and updated widely endorsed Position Statements on transplantation equity, and embedded Community-identified priorities — including workforce development, tailored models of care, and ongoing accountability — into national policy recommendations. Our collective efforts have produced peer-reviewed publications, developed a national data platform for equity metrics, and directly contributed to the National Strategy for Organ Donation, Retrieval and Transplantation. Critically, the NIKTT is a strategic co-design partner with the Federal Department of Health to develop a community-led approach to implementing the strategy.
Conclusion:
Early NIKTT-related work shows improvements in equity, including increased waitlisting rates, but national disparities remain. Continuing work must turn strategy into practice through structures that sustain accountability, cultural safety, and Community priorities.
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