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Comparative Study
. 2016 Aug;27(8):2511-8.
doi: 10.1681/ASN.2015030293. Epub 2016 Feb 4.

Reduced Racial Disparity in Kidney Transplant Outcomes in the United States from 1990 to 2012

Tanjala S Purnell  1 , Xun Luo  2 , Lauren M Kucirka  3 , Lisa A Cooper  4 , Deidra C Crews  5 , Allan B Massie  3 , L Ebony Boulware  6 , Dorry L Segev  3
Affiliations
Comparative Study

Reduced Racial Disparity in Kidney Transplant Outcomes in the United States from 1990 to 2012

Tanjala S Purnell et al. J Am Soc Nephrol. 2016 Aug.

Abstract

Earlier studies reported inferior outcomes among black compared with white kidney transplant (KT) recipients. We examined whether this disparity improved in recent decades. Using the Scientific Registry of Transplant Recipients and Cox regression models, we compared all-cause graft loss among 63,910 black and 145,482 white adults who received a first-time live donor KT (LDKT) or deceased donor KT (DDKT) in 1990-2012. Over this period, 5-year graft loss after DDKT improved from 51.4% to 30.6% for blacks and from 37.3% to 25.0% for whites; 5-year graft loss after LDKT improved from 37.4% to 22.2% for blacks and from 20.8% to 13.9% for whites. Among DDKT recipients in the earliest cohort, blacks were 39% more likely than whites to experience 5-year graft loss (adjusted hazard ratio [aHR], 1.39; 95% confidence interval [95% CI], 1.32 to 1.47; P<0.001), but this disparity narrowed in the most recent cohort (aHR, 1.10; 95% CI, 1.03 to 1.18; P=0.01). Among LDKT recipients in the earliest cohort, blacks were 53% more likely than whites to experience 5-year graft loss (aHR, 1.53; 95% CI, 1.27 to 1.83; P<0.001), but this disparity also narrowed in the most recent cohort (aHR, 1.37; 95% CI, 1.17 to 1.61; P<0.001). Analyses revealed no statistically significant differences in 1-year or 3-year graft loss after LDKT or DDKT in the most recent cohorts. Our findings of reduced disparities over the last 22 years driven by more markedly improved outcomes for blacks may encourage nephrologists and patients to aggressively promote access to transplantation in the black community.

Keywords: Epidemiology; and outcomes; end-stage renal disease; ethnicity; kidney transplantation; transplant outcomes.

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Figures

Figure 1.
Figure 1.
Time trends in all-cause graft loss after KT for white and black adults in the United States. The graphs illustrate unadjusted trends in 1-year, 3-year, and 5-year all-cause graft loss (%) after (A) LDKT and (B) DDKT, stratified by recipient race.
See this image and copyright information in PMC

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References

    1. Cecka M: Clinical outcome of renal transplantation. Factors influencing patient and graft survival. Surg Clin North Am 78: 133–148, 1998 - PubMed
    1. Jofré R, López-Gómez JM, Moreno F, Sanz-Guajardo D, Valderrábano F: Changes in quality of life after renal transplantation. Am J Kidney Dis 32: 93–100, 1998 - PubMed
    1. Purnell TS, Auguste P, Crews DC, Lamprea-Montealegre J, Olufade T, Greer R, Ephraim P, Sheu J, Kostecki D, Powe NR, Rabb H, Jaar B, Boulware LE: Comparison of life participation activities among adults treated by hemodialysis, peritoneal dialysis, and kidney transplantation: a systematic review. Am J Kidney Dis 62: 953–973, 2013 - PMC - PubMed
    1. U.S. Renal Data System : USRDS 2013 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, Bethesda, MD, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2013
    1. Fan PY, Ashby VB, Fuller DS, Boulware LE, Kao A, Norman SP, Randall HB, Young C, Kalbfleisch JD, Leichtman AB: Access and outcomes among minority transplant patients, 1999-2008, with a focus on determinants of kidney graft survival. Am J Transplant 10(4 Pt 2): 1090–1107, 2010 - PMC - PubMed

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