Kidney Week

Abstract: TH-PO774

Outcomes among Hispanic Kidney Transplant Recipients Including Non-US Citizens

Session Information

• Transplantation: Clinical - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Giusti, Sixto G., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Sixto G. Giusti, MD, FASN

• Arrigain, Susana, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Susana Arrigain

• Lopez, Rocio, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Rocio Lopez, MS, MPH

• Ramos, Marco, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Marco Ramos, MD

• Karakadze, Marko Alexander, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Marko Alexander Karakadze, MD

• Cervantes, Lilia, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Lilia Cervantes, MD

• Schold, Jesse D., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Jesse D. Schold, MEd, MS, PhD

• Pomfret, Elizabeth Anne, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Elizabeth Anne Pomfret, MD, PhD

Background

Hispanics experience a faster progression of CKD to kidney failure compared to non-Hispanic Whites (NHW). They are also less likely to receive pre-dialysis nephrology care, be referred for transplant evaluation, be listed for transplant, and receive a transplant. This study compares transplant outcomes between Hispanic individuals and NHW, to demonstrate the benefit of increasing access to transplantation to this patient population.

Methods

We evaluated kidney transplant recipients from 2010-2021 using the SRTR data. For the main outcomes we compared time to post-transplant patient mortality and graft failure between Hispanic and NHW recipients using Cox proportional models adjusted for donor and recipient characteristics.

Results

Among 212,559 kidney recipients, 17% were Hispanic and 47% were NHW. Among Hispanics, 27.5% were non-US citizens. Hispanic recipients were younger than NHW recipients (mean age 48.8+14.1 vs. 53.5+14.0). The average wait list months for Hispanics was 18.4 compared to 12.7 for NHW recipients. 28% of Hispanics had private health insurance compared to 42% of NHW. In adjusted models, Hispanics had a lower HR of death and graft failure compared to NHW recipients (HR=0.70, 95 % CI: 0.67, 0.73, and HR=0.79, 95% CI: 0.76, 0.82, respectively). We found similar results when comparing Hispanic non-US citizens to NHW recipients (HR=0.68, 95 % CI: 0.63, 0.74, and HR=0.73, 95% CI: 0.68, 0.78; Figure 1).

Conclusion

Despite many social and economic challenges and irrespective of citizenship status, Hispanic transplant recipients had a lower HR of death and better graft survival compared to NHW transplant recipients. Future studies that focus on reducing disparities throughout the transplant process and improve access to transplantation in this population are warranted.