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. 2010 Apr;10(4 Pt 2):1090-107.
doi: 10.1111/j.1600-6143.2009.03009.x.

Access and outcomes among minority transplant patients, 1999-2008, with a focus on determinants of kidney graft survival

P-Y Fan  1 , V B Ashby, D S Fuller, L E Boulware, A Kao, S P Norman, H B Randall, C Young, J D Kalbfleisch, A B Leichtman
Affiliations

Access and outcomes among minority transplant patients, 1999-2008, with a focus on determinants of kidney graft survival

P-Y Fan et al. Am J Transplant. 2010 Apr.

Abstract

Coincident with an increasing national interest in equitable health care, a number of studies have described disparities in access to solid organ transplantation for minority patients. In contrast, relatively little is known about differences in posttransplant outcomes between patients of specific racial and ethnic populations. In this paper, we review trends in access to solid organ transplantation and posttransplant outcomes by organ type, race and ethnicity. In addition, we present an analysis of categories of factors that contribute to the racial/ethnic variation seen in kidney transplant outcomes. Disparities in minority access to transplantation among wait-listed candidates are improving, but persist for those awaiting kidney, simultaneous kidney and pancreas and intestine transplantation. In general, graft and patient survival among recipients of solid organ transplants is highest for Asians and Hispanic/Latinos, intermediate for whites and lowest for African Americans. Although much of the difference in outcomes between racial/ethnic groups can be accounted for by adjusting for patient characteristics, important observed differences remain. Age and duration of pretransplant dialysis exposure emerge as the most important determinants of survival in an investigation of the relative impact of center-related versus patient-related variables on kidney graft outcomes.

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Conflict of interest statement

Conflict of Interest Statement: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Ratio of percent of kidney transplants and percent on active waiting list at end of prior year, 2000–2008
Figure 2
Figure 2. Adjusted deceased donor kidney graft survival by race/ethnicity
Figure 3
Figure 3. Adjusted deceased donor kidney patient survival by race/ethnicity
Figure 4
Figure 4. Ratio of percent of liver transplants and percent on active waiting list at end of prior year, 2000–2008
Figure 5
Figure 5. Adjusted deceased donor liver patient survival by race/ethnicity
Figure 6
Figure 6. Ratio of percent of heart transplants and percent on active waiting list at end of prior year, 2000–2008
Figure 7
Figure 7. Adjusted heart patient survival by race/ethnicity
Figure 8
Figure 8. Ratio of percent of lung transplants and percent on active waiting list at end of prior year, 2000–2008
Figure 9
Figure 9. Adjusted deceased donor lung patient survival by race/ethnicity
Figure 10
Figure 10. Ratio of percent of SPK transplants and percent on active waiting list at end of prior year, 2000–2008
Figure 11
Figure 11. Adjusted deceased donor SPK kidney graft survival by race/ethnicity
Figure 12
Figure 12. Adjusted deceased donor SPK pancreas graft survival by race/ethnicity
Figure 13
Figure 13. Adjusted deceased donor SPK patient survival by race/ethnicity
Figure 14
Figure 14. Adjusted deceased donor intestine patient survival by race/ethnicity
See this image and copyright information in PMC

References

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