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. 2017 Apr;213(4):666-672.
doi: 10.1016/j.amjsurg.2016.11.024. Epub 2016 Nov 18.

Outcome disparities between African Americans and Caucasians in contemporary kidney transplant recipients

David J Taber  1 , Leonard E Egede  2 , Prabhakar K Baliga  3
Affiliations

Outcome disparities between African Americans and Caucasians in contemporary kidney transplant recipients

David J Taber et al. Am J Surg. 2017 Apr.

Abstract

Background: Racial disparities in African-American (AA) kidney transplant have persisted for nearly 40 years, with limited data available on the scope of this issue in the contemporary era of transplantation.

Methods: Descriptive retrospective cohort study of US registry data including adult solitary kidney transplants between Jan 1, 2005 to Dec 31, 2009.

Results: 60,695 recipients were included; 41,426 Caucasians (68%) and 19,269 AAs (32%). At baseline, AAs were younger, had lower college graduation rates, were more likely to be receiving public health insurance and have diabetes. At one-year post-transplant, AAs had 62% higher risk of graft loss (RR 1.62, 95% CI 1.50-1.75) which increased to 93% at five years (RR 1.93, 95% CI 1.85-2.01). Adjusted risk of graft loss, accounting for baseline characteristics, was 60% higher in AAs (HR 1.61 [1.52-1.69]). AAs had significantly higher risk of acute rejection and delayed graft function.

Conclusion: AAs continue to experience disproportionately high rates of graft loss within the contemporary era of transplant, which are related to a convergence of an array of socioeconomic and biologic risk factors.

Keywords: Acute rejection; African Americans; Graft loss; Kidney transplant.

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Figures

Figure 1
Figure 1
Clinical outcomes for adult kidney transplant recipients transplanted between 2005 and 2009, stratified by race, which include death-censored graft loss (left side of Figure) and mortality (right side of Figure), at 1, 3, 5 years and end of follow-up
Figure 2
Figure 2
Death-censored graft survival curve estimates using Cox regression, stratified by race. The top figure is unadjusted and the bottom figure is adjusted for baseline recipient, donor and transplant characteristics *adjusted for age, sex, functional status, insurance, education. BMI, comorbidities, transplant characteristics, donor characteristics and baseline immunosuppression.
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References

    1. Morris P, Knechtle SJ. Kidney transplantation-principles and practice. Elsevier Health Sciences; 2013.
    1. Rana A, Gruessner A, Agopian VG, et al. Survival benefit of solid-organ transplant in the united states. JAMA Surgery. 2015;150(3):252–259. - PubMed
    1. Opelz G, Mickey MR, Terasaki PI. Influence of race on kidney transplant survival. Transplant Proc. 1977;9(1):137–142. - PubMed
    1. Matas A, Smith J, Skeans M, et al. OPTN/SRTR 2012 annual data report: Kidney. Am J Transplant. 2014;14(S1):11–44. - PubMed
    1. Young CJ, Gaston RS. Renal transplantation in black Americans. N Engl J Med. 2000;343(21):1545–1552. - PubMed