Purpose: We recently demonstrated narrowed racial/ethnic disparities in adult kidney transplant (KT) outcomes in the US. The goal of this study was to examine twenty-year trends in pediatric KT outcomes to determine whether racial/ethnic disparities improved over time.

Methods: Using OPTN data, we performed Cox proportional hazards regression models to compare patient outcomes among 3,295 White and 2,049 Black children (aged 0-17 years) who received a KT in the US between January 1, 1995 and December 31, 2014. We adjusted regression models for differences in recipient, donor, and transplant center factors.

Results: From 1995 to 2014, patient survival after KT improved for black and white recipients. (Figure 1) However, racial/ethnic disparities in patient survival worsened over time (p<0.05 for statistical interaction). In 1995, the adjusted hazard ratio (aHR) comparing patient survival in Black versus White pediatric KT recipients was 0.99 (95% CI: 0.79‐1.25, p=0.9), suggesting no statistically significant differences in mortality. However, in 2014, the aHR comparing patient survival in Black versus White KT recipients was 1.75 (95% CI: 1.15‐2.65, p=0.008).

Conclusions: Racial/ethnic disparities in survival among pediatric kidney transplant recipients worsened over the last two decades in the US. These findings suggest that strategies for addressing disparities in KT outcomes among pediatric recipients should be revisited.

CITATION INFORMATION: Purnell T., Luo X., Cooper L., Crews D., Covarrubias K., Massie A., Segev D. Worsening Racial/Ethnic Disparities in Pediatric Kidney Transplant Outcomes in the US Am J Transplant. 2017;17 (suppl 3).

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