Ambient Air Pollution and Post-Transplant Mortality among US Kidney Transplant Recipients
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 2Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
Meeting: 2020 American Transplant Congress
Abstract number: A-251
Keywords: High-risk, Kidney transplantation, Mortality, Risk factors
Session Information
Session Name: Poster Session A: Non-Organ Specific: Disparities to Outcome and Access to Healthcare
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Long-term exposure to fine particulate matter (PM2.5) has been associated with increased mortality in the general US population and has been shown to negatively affect renal function. Kidney transplant recipients may be especially vulnerable to the effects of air pollution. Our objective was to investigate associations of PM2.5 concentrations with mortality among US kidney transplant recipients.
*Methods: We studied 96,109 kidney transplant recipients identified from the Scientific Registry of Transplant Recipients who received their transplant between January 1, 2010 and December 31, 2016 and were followed for mortality through June 30, 2019. Annual PM2.5 concentration at the time of transplant was estimated at each recipient’s zip code using data from NASA’s SEDAC Global Annual PM2.5 Grids from MODIS, MISR and SeaWiFS Aerosol Optical Depth. Multilevel cox proportional hazards models were used to estimate hazard ratios (HR, 95% confidence intervals [CI]) for post-transplant mortality by zip code PM2.5 concentration.
*Results: Sixty-one percent of recipients were male, 48% non-Hispanic (NH) White and the median age at transplant was 53 years of age. The median zip code PM2.5 concentration was 9.1 ug/m3. After a median of 4.0 years of follow-up, there were 14,260 deaths. After multivariable adjustment, recipients living in zip codes in the highest quartile of PM2.5 exposure (>10.7 ug/m3) had 5% higher (HR: 1.05, 95% CI: 1.00, 1.10) risk for post-transplant mortality compared to recipients in zip codes in the lowest quartile of PM2.5 exposure (<7.6 ug/m3). These finding were stronger in recipients >65 years of age (HR: 1.09, 95% CI: 1.01, 1.18) and in NH White and NH Black recipients compared to recipients of other race/ethnicities.
*Conclusions: Among US kidney transplant recipients, living in areas with higher exposure to PM2.5 was associated with increased risk for mortality following transplantation. These findings provide evidence of adverse effects related to exposure to ambient air pollution for kidney transplant recipients at concentrations below the current national standard (12 ug/m3). Additional management of kidney transplant recipients who might be exposed to moderate air pollution may help reduce mortality in this population.
To cite this abstract in AMA style:
Jones MR, Feng Y, Chu N, Segev D, McAdams-DeMarco M. Ambient Air Pollution and Post-Transplant Mortality among US Kidney Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/ambient-air-pollution-and-post-transplant-mortality-among-us-kidney-transplant-recipients/. Accessed May 16, 2025.« Back to 2020 American Transplant Congress