Abstract: TH-PO864
Equity in Kidney Transplant Allocation: Graft Survival Outcomes for Blood Group B Recipients from A2/A2B- and ABO-Compatible Donors
Session Information
- Race, Ethnicity, and Gender in Kidney Health and Care
October 24, 2024 | Location: Exhibit Hall, 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
- Ali, Hatem, University Hospitals North Midlands, Stoke on Trent, United Kingdom
- Daoud, Ahmed, Medical University of South Carolina, Charleston, United States
- Fulop, Tibor, Medical University of South Carolina, Charleston, South Carolina, United States
Background
Disparities in kidney transplant allocations affect blood group B candidates, who are predominantly from minority groups. Prior studies have indicated successful outcomes from transplanting kidneys from donors with non-A1/non-A1B (A2/A2B) subtypes to blood group B recipients.
Methods
This retrospective cohort study utilized the United Network for Organ Sharing (UNOS) database, covering the period from January 1, 2015, to June 1, 2022, with follow-up data until June 1, 2023. The study included 110,826 adult deceased kidney donor transplant recipients, of which 109,353 (98.24%) received ABO-compatible transplants. We compared graft survival between blood group B recipients receiving kidneys from A2B or B group donors (incompatible group) and those receiving ABO-compatible kidneys. Covariates such as donor age, sex, ethnicity, BMI, hypertension, diabetes, transplant factors (PRA, HLA mismatch, cold ischemia time), and recipient factors (age, sex, ethnicity, cause of renal failure, BMI, dialysis prior to transplant, number of previous transplants) were adjusted for in the analysis.
Results
Our findings show no significant difference in graft survival between the ABO-compatible and incompatible groups, with a hazard ratio of 1.08 (95% CI: 0.91-1.27; p=0.345). This suggests equivalent outcomes in both groups, supporting the viability of expanding donor eligibility criteria to include A2/A2B donors for blood group B recipients.
Conclusion
The study supports the ongoing efforts to improve equity in kidney transplant allocations through broader use of A2/A2B donors for blood group B recipients, particularly benefiting minority populations. This could potentially mitigate disparities in transplant access and outcomes for this group, aligning with changes implemented in the kidney allocation system (KAS). Further research is needed to explore the long-term impacts of these policy changes on transplant equity.