ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Advanced Search

Access to and Survival Benefit of Kidney Transplantation in Patients with Sickle Cell Disease-Associated End-Stage Renal Disease in the United States

S. Bae, M. Johnson, A. Massie, X. Luo, C. Haywood Jr., S. Lanzkron, M. Grams, D. Segev, T. Purnell

Johns Hopkins School of Medicine, Baltimore, MD

Meeting: 2020 American Transplant Congress

Abstract number: C-237

Keywords: Survival

Session Information

Date: Saturday, May 30, 2020

Session Name: Poster Session C: Non-Organ Specific: Disparities to Outcome and Access to Healthcare

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

Related Abstracts
  • Geographic Variation in Listing for Kidney Transplantation: A State-Level Assessment of Access among Patients with End-Stage Renal Disease in the United States
  • Survival Benefit of Kidney Transplantation in US Adults with Sickle Cell Nephropathy.

*Purpose: Patients with end-stage renal disease due to sickle cell disease (SCD-ESRD) have high mortality, which might be reduced by kidney transplantation (KT). However, whether KT is desirable in SCD-ESRD patients is controversial, potentially limiting their access to KT, because SCD-ESRD KT recipients may experience higher mortality than other KT recipients. Survival benefit, or reduction in mortality associated with KT, is unknown in SCD-ESRD patients. We aimed to quantify survival benefit of KT and to compare the access to KT in SCD-ESRD versus non-SCD-ESRD patients.

*Methods: Using USRDS and SRTR data, we studied adult SCD-ESRD and non-SCD-ESRD patients who began routine dialysis or were added to the national KT waitlist in 1998-2017. To quantify survival benefit, we created SCD and non-SCD matched pairs (SCD KT recipient and SCD waitlisted candidate; and non-SCD KT recipient and non-SCD waitlisted candidate) using sequential stratification. Survival benefit of KT was defined as reduction in mortality associated with receiving KT versus remaining on dialysis awaiting KT, measured in both absolute risk difference and hazard ratio (HR) for mortality. To compare the access to KT, we estimated HRs for receiving KT in SCD-ESRD versus non-SCD-ESRD patients, treating death as a competing risk.

*Results: Among 189 SCD and 220,251 non-SCD KT recipients matched to waitlisted candidates, KT was associated with decreased mortality. Absolute risk difference was 0.920.339.8 percentage-points (PP) in SCD and 19.219.820.4 PP in non-SCD patients at 10-year post-KT. HR was 0.360.570.91 in SCD and 0.530.540.55 in non-SCD patients; these HRs did not differ between SCD and non-SCD patients (interaction p=0.8). Nonetheless, SCD-ESRD patients were less likely to receive KT than non-SCD-ESRD patients (subdistribution HR=0.61­0.730.87). Similar disparities were found among waitlisted candidates (subdistribution HR=0.530.620.72), even after accounting for differences in mortality and factors constituting the kidney allocation criteria (cause-specific HR=0.710.820.94).

*Conclusions: SCD-ESRD and non-ESRD populations received similar survival benefit from KT. Nonetheless, SCD-ESRD patients were less likely to receive KT, even after waitlist registration. Our findings suggest that access to KT should be improved for SCD-ESRD patients.

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Bae S, Johnson M, Massie A, Luo X, Jr CHaywood, Lanzkron S, Grams M, Segev D, Purnell T. Access to and Survival Benefit of Kidney Transplantation in Patients with Sickle Cell Disease-Associated End-Stage Renal Disease in the United States [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/access-to-and-survival-benefit-of-kidney-transplantation-in-patients-with-sickle-cell-disease-associated-end-stage-renal-disease-in-the-united-states/. Accessed February 26, 2021.

« Back to 2020 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
      • Penis Transplantation: First U.S. Experience.
      • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
      • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
      • Evidence of a Clinically Significant Drug-Drug Interaction between Cannabidiol and Tacrolimus: A Case Report
      • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes

      Visit Our Partner Sites

      American Transplant Congress (ATC)

      Visit the official site for the American Transplant Congress »

      American Journal of Transplantation

      The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

      American Society of Transplantation (AST)

      An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

      American Society of Transplant Surgeons (ASTS)

      The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

      Copyright © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

      Privacy Policy

      loading Cancel
      Post was not sent - check your email addresses!
      Email check failed, please try again
      Sorry, your blog cannot share posts by email.
      This site uses cookies: Find out more.