BACKGROUND: Previous multivariate analysis performed between April 1, 1994, and December 31, 2000 from the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) database has shown that kidneys from black donors were associated with lower graft survival. We compared graft and patient survival of different kidney donor-to-recipient ethnic combinations to see if this result still holds on a recent cohort of US kidney transplants. METHODS: We included 72,495 recipients of deceased and living donor kidney alone transplants from 2001 to 2005. A multivariate Cox regression method was used to analyze the effect of donor-recipient ethnicity on graft and patient survival within 5 years of transplant, and to adjust for the effect of other donor, recipient, and transplant characteristics. Results are presented as hazard ratios (HR) with the 95% confidence limit (CL) and P values. RESULTS: Adjusted HRs of donor-recipient patient survival were: white to white (1); and white to black (1.22; P = .001). Graft survival HRs were black to black (1.40; P <.001); black to white (1.35; P <.001); black to Hispanic (0.87; P = .18); and black to Asian (0.69; P =.05). SUMMARY: Black donor kidneys are associated with significantly lower graft survival when transplanted into whites or blacks and are only associated with lower patient survival when these kidneys are transplanted into white recipients. The graft and patient survival rates for Asian and Latino/Hispanic recipients, however, were not affected by donor ethnicity. This analysis underscores the need for research to better understand the reasons for these disparities and how to improve the posttransplant graft survival rates of black kidney recipients.
BACKGROUND: Previous multivariate analysis performed between April 1, 1994, and December 31, 2000 from the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) database has shown that kidneys from black donors were associated with lower graft survival. We compared graft and patient survival of different kidney donor-to-recipient ethnic combinations to see if this result still holds on a recent cohort of US kidney transplants. METHODS: We included 72,495 recipients of deceased and living donor kidney alone transplants from 2001 to 2005. A multivariate Cox regression method was used to analyze the effect of donor-recipient ethnicity on graft and patient survival within 5 years of transplant, and to adjust for the effect of other donor, recipient, and transplant characteristics. Results are presented as hazard ratios (HR) with the 95% confidence limit (CL) and P values. RESULTS: Adjusted HRs of donor-recipient patient survival were: white to white (1); and white to black (1.22; P = .001). Graft survival HRs were black to black (1.40; P <.001); black to white (1.35; P <.001); black to Hispanic (0.87; P = .18); and black to Asian (0.69; P =.05). SUMMARY: Black donor kidneys are associated with significantly lower graft survival when transplanted into whites or blacks and are only associated with lower patient survival when these kidneys are transplanted into white recipients. The graft and patient survival rates for Asian and Latino/Hispanic recipients, however, were not affected by donor ethnicity. This analysis underscores the need for research to better understand the reasons for these disparities and how to improve the posttransplant graft survival rates of black kidney recipients.
Authors: Jeffrey B Kopp; Michael W Smith; George W Nelson; Randall C Johnson; Barry I Freedman; Donald W Bowden; Taras Oleksyk; Louise M McKenzie; Hiroshi Kajiyama; Tejinder S Ahuja; Jeffrey S Berns; William Briggs; Monique E Cho; Richard A Dart; Paul L Kimmel; Stephen M Korbet; Donna M Michel; Michele H Mokrzycki; Jeffrey R Schelling; Eric Simon; Howard Trachtman; David Vlahov; Cheryl A Winkler Journal: Nat Genet Date: 2008-09-14 Impact factor: 38.330
Authors: W H Linda Kao; Michael J Klag; Lucy A Meoni; David Reich; Yvette Berthier-Schaad; Man Li; Josef Coresh; Nick Patterson; Arti Tandon; Neil R Powe; Nancy E Fink; John H Sadler; Matthew R Weir; Hanna E Abboud; Sharon G Adler; Jasmin Divers; Sudha K Iyengar; Barry I Freedman; Paul L Kimmel; William C Knowler; Orly F Kohn; Kristopher Kramp; David J Leehey; Susanne B Nicholas; Madeleine V Pahl; Jeffrey R Schelling; John R Sedor; Denyse Thornley-Brown; Cheryl A Winkler; Michael W Smith; Rulan S Parekh Journal: Nat Genet Date: 2008-09-14 Impact factor: 38.330
Authors: C O Callender; W S Cherikh; P V Miles; A Hermesch; G Maddox; J Nash; A Hernandez; B Burston Journal: Transplant Proc Date: 2008-05 Impact factor: 1.066
Authors: A B Massie; J Leanza; L M Fahmy; E K H Chow; N M Desai; X Luo; E A King; M G Bowring; D L Segev Journal: Am J Transplant Date: 2016-02-26 Impact factor: 8.086
Authors: Jennifer M Kwan; Zahraa Hajjiri; Yi Fan Chen; Ahmed Metwally; David L Perkins; Patricia W Finn Journal: J Racial Ethn Health Disparities Date: 2017-12-21
Authors: A M Reeves-Daniel; J A DePalma; A J Bleyer; M V Rocco; M Murea; P L Adams; C D Langefeld; D W Bowden; P J Hicks; R J Stratta; J-J Lin; D F Kiger; M D Gautreaux; J Divers; B I Freedman Journal: Am J Transplant Date: 2011-04-12 Impact factor: 8.086
Authors: B A Julian; R S Gaston; W M Brown; A M Reeves-Daniel; A K Israni; D P Schladt; S O Pastan; S Mohan; B I Freedman; J Divers Journal: Am J Transplant Date: 2017-01-03 Impact factor: 8.086
Authors: B I Freedman; B A Julian; S O Pastan; A K Israni; D Schladt; M D Gautreaux; V Hauptfeld; R A Bray; H M Gebel; A D Kirk; R S Gaston; J Rogers; A C Farney; G Orlando; R J Stratta; S Mohan; L Ma; C D Langefeld; P J Hicks; N D Palmer; P L Adams; A Palanisamy; A M Reeves-Daniel; J Divers Journal: Am J Transplant Date: 2015-03-24 Impact factor: 8.086