Abstract: FR-PO879
Transplantation Outcome Racial Disparities in Autosomal Dominant Polycystic Kidney Disease
Session Information
- Diversity and Equity in Kidney Health - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- McGill, Rita L., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Chapman, Arlene B., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
Background
Autosomal dominant polycystic kidney disease (ADPKD) patients access to pre-emptive and living donor transplantation varies by race throughout the United States. In this analysis, we examined transplant outcomes by race among patients with ADPKD.
Methods
OPTN/UNOS files were used to identify patients age>=30 with ADPKD who received kidney-only transplants. Race was stratified as White (W), African American (AA), Hispanic (H), and Asian (A). Cox models were used to calculate hazard ratios (HR) for graft failure, using (W) as the reference. The model was then adjusted for age, sex, BMI, cold ischemia time, living donation, pre-emptive transplant, diabetes, use of induction therapy, steroid maintenance, and HLA mismatch.
Results
30898 ADPKD transplant recipients were assessed. Patient characteristics are outlined in Table 1. The unadjusted HR for graft failure among AA was 1.55 (1.45, 1.66) P<0.001, and remained 1.30 (1.20, 1.41) P<0.001 after adjustment. Outcome disparities were not observed among H or A patients with ADPKD. (Table 2)
Conclusion
African American ADPKD patients are at higher risk for graft failure after kidney transplant than other patients, above and beyond reduced access to living donor and pre-emptive transplantation. Further work is needed to determine what remediable factors could lead to more equity in transplant outcomes.