Introduction: Patients from ethnic minorities make up an increasing number of recipients of kidney allografts in the UK. Some of these patients have language barriers that may contribute to health inequalities in the NHS. This study aimed to test the hypothesis that non-English speakers may have poorer outcomes after kidney transplantation compared to English speakers.

Methods: Data was extracted for all kidney allograft recipients transplanted between 2007 and 2015. Electronic records were then manually searched to facilitate data linkage between various sources to create a comprehensive database of baseline demographics, donor details, clinical/biochemical parameters, histology and clinical events. Patients were linked to data held with the Language and Communication Services to identify patients who ever required interpreting services.

Results: A total of 1,140 post-transplant patients with a median follow up to 4.4 years were analysed. Interpreters had been requested for 40 recipients, with commonest languages including Urdu/Punjabi (n=25), Arabic (n=2), Bengali (n=2), Gujrati (n=2) and single cases of 9 other languages. Patients who required interpreting services were more likely to be South Asian (80.0% of users vs 15.4% of non-users, p<0.001) and female (60.0% of users vs 39.5% of non-users, p=0.008). Comparing recipients using versus not using interpreting services, we observed less events of any rejection (2.5% vs 14.8% respectively, p=0.014), cellular rejection (2.5% vs 13.5% respectively, p=0.023) and antibody-mediated rejection (0% vs 3.8% respectively, p=0.217). Specifically looking at South Asians, those using vs not using interpreter services had less events of rejection (3.1% vs 14.8% respectively, p=0.053). They also had equal patient survival (92.5% vs 92.9% respectively, p=0.551), death-censored graft survival (90.0% vs 89.8% respectively, p=0.615) and overall graft survival (82.5% vs 84.1% respectively, p=0.461).

Discussion: Transplant recipients who require interpreting services do not suffer worse post-transplant outcomes. We observed less rejection in these patients. The major confounder are non-English speaking patients who did not utilise interpreting services. Despite this limitation, our results are encouraging for recipients who do not speak English and supports use of professional interpreting services for long-term clinical follow up.

CITATION INFORMATION: Tahir S, Jackson-Spence F, Gillott H, Everson F, Nath J, Sharif A. Outcomes for Kidney Allograft Recipients with Language Barriers Post-Transplantation – A Comparative Analysis. Am J Transplant. 2016;16 (suppl 3).

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