Abstract: TH-OR04
Racial Disparities in Access to Preemptive Living Donor Kidney Transplantation in the United States from 2001-2023
Session Information
- Achieving More Equitable Kidney Care
October 24, 2024 | Location: Room 7, Convention Center
Abstract Time: 05:00 PM - 05:10 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Al Ammary, Fawaz, University of California Irvine, Irvine, California, United States
- Muzaale, Abimereki, Johns Hopkins University, Baltimore, Maryland, United States
- Adeyemo, Simeon, University of California Irvine, Irvine, California, United States
Group or Team Name
- Living Donor Transplant Outcome Collaborative (LDTOC).
Background
Preemptive kidney transplantation for ESRD patients, before dialysis is needed, improves patient survival. However, access depends on early referral for transplant evaluation, as patient eligibility starts when eGFR less or equal 20 ml/min/1.73m2. We studied the impact of race/ethnicity on transplant waitlisting and access to preemptive living donor kidney transplantation over time.
Methods
We used the Scientific Registry of Transplant Recipients of 111,126 adult first-time kidney transplant candidates listed preemptively between 2001 and 2020. Outcome was wait time to preemptive living donor kidney transplantation, with race/ethnicity as the exposure. We used competing risk survival to estimate the cumulative incidence of preemptive transplantation, competing with death. Multivariable Cox regression adjusted for confounders. Analyses were stratified by era (2001–2005, 2006–2010, 2011–2015, and 2016–2020). Patients were followed for 3 years, with last follow-up in Dec. 2023.
Results
Overall, the cumulative incidence of preemptive living donor transplantation for patients on waitlist varied by race [Figure]. Compared to White patients, in the eras 2001–2005, 2006–2010, 2011–2015, and 2016–2020, Black patients were less likely to be transplanted by 52%, 58%, 60%, and 65%; Hispanic patients by 19%, 20%, 25%, and 34%; and Asian patients by 54%, 47%, 42%, and 47%, respectively [Table].
Conclusion
This study highlights persistent racial disparities in access to preemptive living donor kidney transplantation over the last two decades. These findings emphasize the need for interventions to address systemic barriers and ensure equitable access to early transplant evaluation for racial minorities.
Funding
- NIDDK Support