Donor race and outcomes in kidney transplant recipients. (25th July 2012)

• Record Type: Journal Article
• Authors: Molnar, Miklos Z.; Kovesdy, Csaba P.; Bunnapradist, Suphamai; Streja, Elani; Krishnan, Mahesh; Mucsi, Istvan; Norris, Keith C.; Kalantar‐Zadeh, Kamyar
• Is Part Of: Clinical transplantation. Volume 27:Number 1(2013:Jan./Feb.)
• Page Start: 37
• Page End: 51
• Publication Date: 2012-07-25
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/j.1399-0012.2012.01686.x
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr1686-abs-0001"> <title>Abstract</title> <sec id="ctr1686-sec-0001" sec-type="section"> <title>Background</title> <p> African Americans are at greater risk to reach end‐stage renal disease and this risk may carry over in a kidney transplant recipient after kidney transplantation.</p> </sec> <sec id="ctr1686-sec-0002" sec-type="section"> <title>Methods</title> <p>Linking the five‐yr patient data of a large dialysis organization to the <italic> Scientific Registry of Transplant Recipients</italic>, we identified 13 692 hemodialysis patients who underwent first kidney transplantation. Mortality or graft failure and delayed graft function risks were estimated by Cox's regression (hazard ratio [HR] and 95% confidence interval) and logistic regression, respectively.</p> </sec> <sec id="ctr1686-sec-0003" sec-type="section"> <title>Results</title> <p>Patients were 48 ± 14 yr old and included 39% women and 26% patients with diabetes. After adjusting for several relevant clinical and transplant‐related variables, African American donor race was associated with higher all‐cause mortality, with HR of 1.39 (1.09–1.78) for all‐cause mortality, 1.80 (1.17–2.76) for cardiovascular mortality, 1.30 (1.03–1.64) for death‐censored graft loss and 1.31 (1.10–1.57) for combined outcome over the six‐yr observation period. In the non‐African American recipient subcohort, but not in the African American recipient subcohort, African American donor race was associated with higher risk of death‐censored graft loss (2.24 [1.44–3.49]) in our fully adjusted model.</p> </sec> <sec id="ctr1686-sec-0004" sec-type="section"> <title>Conclusions</title> <p> African American donor race was associated with increased all‐cause and cardiovascular mortality and graft loss.</p> </sec> </abstract>