Racial and Ethnic Disparities in Access to Living Donor Kidney Transplantation in the US: Have We Made Any Progress among Pediatric Candidates over the Last Twenty Years?
1Johns Hopkins School of Medicine, Baltimore, MD, 2Nationwide Children’s Hospital, Columbus, OH
Meeting: 2019 American Transplant Congress
Abstract number: 614
Keywords: African-American, Donation, Hispanic, Kidney transplantation
Session Information
Session Name: Concurrent Session: Non-Organ Specific: Disparities and Access to Healthcare II
Session Type: Concurrent Session
Date: Tuesday, June 4, 2019
Session Time: 4:30pm-6:00pm
Presentation Time: 4:42pm-4:54pm
Location: Room 208
*Purpose: A recent JAMA study demonstrated worsening disparities in access to living donor kidney transplantation (LDKT) among adults in the US. We examined twenty-year trends in LDKT to determine whether disparities among pediatric candidates changed over time.
*Methods: Using OPTN data and multivariable Cox and competing risk regression models, we examined changes over time in LDKT among 12,763 pediatric KT waitlist candidates from 1995 to 2015. We adjusted regression models for differences in ESRD etiology, age at listing, sex, body mass index, panel reactive antibody, and ABO blood type. We also accounted for racial/ethnic differences in mortality and receipt of deceased donor KT among candidates.
*Results: From 1995 to 2014, receipt of LDKT decreased among pediatric candidates. (Figure 1) Racial/ethnic disparities in receipt of LDKT became worse over time. In 1995, compared with receipt of LDKT in White children, the adjusted sub-hazard ratio (aSHR) from competing risk models for Black children was 0.34 (95% CI: 0.24‐0.49) and for Hispanic children was 0.54 (95% CI: 0.39‐0.74). In 2014, compared with receipt of LDKT in White children, the aSHR for Black children was 0.26 (95% CI: 0.16‐0.44) and for Hispanic children was 0.40 (95% CI: 0.27‐0.59).
*Conclusions: Racial/ethnic disparities in LDKT among pediatric kidney transplant candidates became worse over the last two decades in the US. Strategies to elucidate and intervene on mechanisms driving disparities in LDKT access among pediatric KT candidates are needed.
To cite this abstract in AMA style:
Purnell T, Bae S, Luo X, Chen A, Crews D, Cooper L, II ONBignall, Covarrubias K, Segev D. Racial and Ethnic Disparities in Access to Living Donor Kidney Transplantation in the US: Have We Made Any Progress among Pediatric Candidates over the Last Twenty Years? [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/racial-and-ethnic-disparities-in-access-to-living-donor-kidney-transplantation-in-the-us-have-we-made-any-progress-among-pediatric-candidates-over-the-last-twenty-years/. Accessed June 27, 2025.« Back to 2019 American Transplant Congress