Abstract: FR-PO802
Impact of Race on Kidney Transplant Outcomes in Patients with ADPKD
Session Information
- Diversity and Equity: Kidney Transplant Research
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- McGill, Rita L., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Krishnamoorthy, Sambhavi, University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Girimaji Satishchandra, Niveditha, 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) is equally present in all ethnicities. Disparities in access to transplant (Tx) exist for African American (AA) and Hispanic (H) ADPKD patients. We examined outcomes among ADPKD patients who received kidney Tx, by self-reported race.
Methods
OPTN/UNOS files were used to identified ADPKD patients age>30 receiving Tx 2000-2021, and ethnicity was White (W), AA, H, or Asian (A). A Cox model provided hazard ratios for death and a subdistribution hazards model for graft failure accounted for death as a competing outcome. Adjustments for age, gender, BMI, HLA/DR mismatch, dialysis years, diabetes, immunosuppression, CMV, cold ischemia, center distance, PRA, private insurance, donor KDPI, delayed graft function, and living/pre-emptive Tx were included with W as the reference.
Results
Among 32,611 ADPKD recipients, W, AA, H, and A were 76.4, 10.7, 9.8,and 3.1% respectively (Table 1). Compared to W, all others had more dialysis years and more mismatches, but less private insurance and fewer living and preemptive Tx. There was more delayed graft function, despite more lymphocyte depleting induction and corticosteroids.
Conclusion
Tx recipient survival did not differ between W and AA ADPKD patients, but was superior in H and A patients. Decreased allograft survival in African American ADPKD patients persisted after adjustment, suggesting that additional biological or social/economic factors remain to be identified.
Patient Characteristics by Race
Patient and Allograft Survival