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Kidney Week

Abstract: TH-PO728

Does Race Impact Outcomes in Kidney Transplant Recipients with Obesity? A Mate Kidney Analysis

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Sureshkumar, Kalathil K., Allegheny Health Network, Pittsburgh, Pennsylvania, United States
  • Daloul, Reem, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
  • Chopra, Bhavna, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
  • McGill, Rita L., University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States
Background

Epidemiological studies have shown favorable impacts of both high body mass index (BMI) and African American (AA) race on the outcomes in patients on long-term dialysis. A mate-kidney model was used to examine the differential impact of recipient race on the outcomes of obese kidney transplant recipients (KTRs).

Methods

Using OPTN/UNOS database from 2000 to 2023, we identified deceased donors with two adult first-time KTRs who were discordant for recipient race. AA recipients were compared to white recipients for outcomes including transplant hospital length of stay (LOS), delayed graft function (DGF; dialysis in the first post-transplant week), overall graft failure (GF), death-censored GF and patient death. Findings were evaluated with Kaplan-Meier survival plots and McNemar tests.

Results

During the study period, there were 6052 obese recipients who received mate-kidneys from 3026 donors in which one recipient was AA and the other was white. Median hospital LOS did not differ by race. The incidence of DGF was higher in AA KTRs (57.6% vs. 42.5%, p<0.001). Kaplan-Meier analysis showed increased GF and death-censored GF in AA compared to white KTRs but AA recipients had lower patient deaths (figure).

Conclusion

Despite increased risk for DGF and inferior graft outcomes, obese AA recipients had enhanced patient survival compared to their white counterparts. Further work is warranted to investigate the factors that affect the interaction of race and obesity on graft and patient survival.