Background. Ethnic and gender disparities in solid organ transplantation (tx) have social and clinical implications.General disparities for donor access and complications within clinical-trial, national and center-specific US tx programs have been incompletely studied, but bear important ramifications for improving donor QOL and may impact national and regional rates of organ donation.

Methods. We investigated disparities in organ donation by comparing gender and ethnic trends for 9,593 kidney living donors (LDs) and 2,664 recipients (RPs) from clinical trials in the US in the ImmPort database (https://immport.niaid.nih.gov/), 128,407 LDs and 372,648 RPs in the national database for the United Network for Organ Sharing (UNOS) and 526 LDs and 2,120 RPs locally within the UCSF electronic health records (EHR). We stratify each dataset by the age at donation and appliedunivariate analyses and data visualization techniques to compare trends of gender and races/ethnicities in RP and LD populations separately.

Results. We observed discrepancies in gender and ethnic trends across clinical-trial, national and center-specific data within the LD and RP populations, especially when data was stratified by age of donation. In general, we observe a majority of female LDs and male RPs, in all three datasets. Further, we also uncover subtle differences when we stratify the gender by age of donation. A greater preponderance of female donors under age 25 in UNOS is also recapitulated in the ImmPort clinical trials. But 70% of UNOS kidney tx LDs are of European ancestry, compared to 87% LDs in ImmPort and 43.4% in the UCSF EHR. This discrepancy between clinical-trial, national and center-specific data is even more pronounced when we stratify by age of donation. We observe a similar trend but with less disparity when we compare RP populations: 57% are of European ancestry in UNOS national registry, ImmPort 64%, UCSF EMR has 40%. Additionally, we are able to associate risk factors with poor short and long term donor outcomes.

CITATION INFORMATION: Chen J., Bhattachrya S., Sirota M., Sarwal M., Butte A. Clinical Trials and Electronic Health Records Am J Transplant. 2017;17 (suppl 3).

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