Abstract: FR-PO801
Impact of Race on Estimated Post-Transplant Survival Score 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
- 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
- McGill, Rita L., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
Background
Autosomal dominant polycystic kidney disease (ADPKD) affects individuals of every race equally. Access to kidney transplant (Tx) and post-Tx outcomes may vary by race. Estimated Post Transplant Survival (EPTS) scores are used to allocate high-longevity kidneys to patients who are expected to receive the most years of graft function. We examined EPTS scores in ADPKD by race, and compared these results to Tx recipients with other kidney diseases.
Methods
ADPKD and non-ADPKD patients age>30 years who received Tx 1/2000-3/2021 were selected from OPTN/UNOS data when ethnicity was unambiguously identified as White, African American, Hispanic, or Asian with available EPTS scores. Using the current EPTS table, EPTS percentages were categorized as ≤20%, >20-80%, and >80%. The four components of EPTS (age, diabetes, prior Tx, and years of dialysis) were analyzed by race for both groups.
Results
Overall, ADPKD patients were more likely (43.5%) to have EPTS≤20% compared to other kidney disorders (26.1%). Although African American, Hispanic and Asian ADPKD patients were more likely to have EPTS≤20% than other kidney disorders, differences in EPTS≤20% were greater across race in ADPKD individuals than in those with other kidney disorders. In ADPKD patients, White patients had significantly lower duration of dialysis and EPTS was predominantly determined by dialysis duration. In non-ADPKD patients, diabetes and prior transplantation were more often determinants.
Conclusion
Overall, transplanted ADPKD patients had significantly lower EPTS scores than other transplant recipients. However, increased dialysis time among non-white ADPKD patients leads to less favorable EPTS scores reducing allocation of best-quality kidneys to minority patients with ADPKD.
Expected post transplant survival scores, by diagnosis and race.