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. 2015 Dec;63(12):2485-2493.
doi: 10.1111/jgs.13845. Epub 2015 Dec 11.

Racial and Ethnic Disparities in Graft and Recipient Survival in Elderly Kidney Transplant Recipients

Titilayo O Ilori  1 , Demilade A Adedinsewo  2 , Oluwaseun Odewole  3 , Nosayaba Enofe  1 , Akinlolu O Ojo  4 , William McClellan  1   5 , Rachel E Patzer  5   6
Affiliations

Racial and Ethnic Disparities in Graft and Recipient Survival in Elderly Kidney Transplant Recipients

Titilayo O Ilori et al. J Am Geriatr Soc. 2015 Dec.

Abstract

Objectives: To investigate racial and ethnic differences in graft and recipient survival in elderly kidney transplant recipients.

Design: Retrospective cohort.

Setting: First-time, kidney-only transplant recipients aged 60 and older of age at transplantation transplanted between July 1996 and October 2010 (N = 44,013).

Participants: United Network for Organ Sharing (UNOS) database.

Measurements: Time to graft failure and death obtained from the UNOS database and linkage to the Social Security Death Index. Neighborhood poverty from 2000 U.S. Census geographic data.

Results: Of the 44,013 recipients in the sample, 20% were black, 63% non-Hispanic white, 11% Hispanic, 5% Asian, and the rest "other racial groups." In adjusted Cox models, blacks were more likely than whites to experience graft failure (hazard ratio (HR) = 1.23, 95% confidence interval (CI) = 1.15-1.32), whereas Hispanics (HR = 0.77, 95% CI = 0.70-0.85) and Asians (HR = 0.70, 95% CI = 0.61-0.81) were less likely to experience graft failure. Blacks (HR = 0.84, 95% CI = 0.80-0.88), Hispanics (HR = 0.68, 95% CI = 0.64-0.72), and Asians (HR = 0.62, 95% CI = 0.57-0.68) were less likely than whites to die after renal transplantation.

Conclusion: Elderly blacks are at greater risk of graft failure than white transplant recipients but survive longer after transplantation. Asians have the highest recipient and graft survival, followed by Hispanics. Further studies are needed to assess additional factors affecting graft and recipient survival in elderly adults and to investigate outcomes such as quality of life.

Keywords: elderly; graft survival; kidney transplantation; racial disparities; recipient survival.

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Conflict of interest statement

Conflict of Interest: The authors declare no competing interests.

Figures

Figure 1
Figure 1. Graft Survival among Elderly (>60 years) U.S. Renal Transplant Recipients from July 1996 to October 2010 with Follow-up through December 2011
Kaplan-Meier estimates showing Unadjusted Graft Survival among Elderly Renal Transplant Recipients from July 1996 - October 2010 with recipient follow-up until December 2011
Figure 2
Figure 2. Patient Survival among Elderly (>60 years) U.S. Renal Transplant Recipients from July 1996 to October 2010 with Follow-up through December 2011
Kaplan-Meier estimates showing Unadjusted Patient Survival among Elderly Renal Transplant Recipients from July 1996 - October 2010 with recipient follow-up until December 2011
See this image and copyright information in PMC

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