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Racial and Socioeconomic Influences on Kidney Transplantation. A 10 Year Retrospective Study

A. Arvelakis, S. Lerner, V. Wadhera, V. Delaney, S. Ames, V. Shegal, R. Kent, G. DeBoccardo, N. Singh, S. Florman, R. Shapiro.

Recanati/Miller Transplantation Institute, The Mount Sinai Hospital, New York, NY.

Meeting: 2018 American Transplant Congress

Abstract number: A309

Keywords: African-American, Kidney transplantation, Outcome

Session Information

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

Session Type: Poster Session

Date: Saturday, June 2, 2018

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Introduction: Racial disparities in kidney transplantation are a widely discussed topic. Studies have shown less access to listing and transplantation, and worse graft survival in African Americans compared to Caucasians.

In our institution, African Americans comprise the highest percentage of our listed and transplanted patients; 41% of our listed patients and 42% of our diseased donor recipients are African Americans. Nationally, these percentages are 33% and 25% respectively.

Methods: We studied 1333 African American and Caucasian patients who had kidney transplant in our institution from 1/1/2005-12/31/2014.The primary end points of our study were differences in graft survival, patient survival, cause of graft loss, and incidence of rejection. The secondary end points were differences in access to listing and transplantation.

Results: We found no difference between African Americans and Caucasians in patient survival. We found lower graft survival in African Americans, but when we adjusted for socioeconomic status there was no difference between the two groups. However, the incidence of rejection was higher among African Americans throughout all socioeconomic levels.

We found no difference in access to listing and transplantation.

Caucasians N=696 African Americans N=637
Mean time to listing (days) 85.35 93.84 P=0.19
Median time from listing to transplant (days) 1544.8 1725.42 P=0.14
Patient survival

3 year

5 year

10 year

90%

87%

68%

91%

86%

69%

P=0.2
Graft Survival (adjusted for socioeconomic status)

1 year

3 year

5 year

10 year

94%

90.5%

82.3%

64%

95.5%

85.5%

79.3%

63.2%

P=0.655
Rejection 3.8% 8.6% P=0.001

Discussion: Most studies show lower graft survival in African Americans vs Caucasians. In our institution we did not find such difference when we compared similar socioeconomic groups. However, we did find lower graft survival in patients with lower socioeconomic status irrespective of race.

CITATION INFORMATION: Arvelakis A., Lerner S., Wadhera V., Delaney V., Ames S., Shegal V., Kent R., DeBoccardo G., Singh N., Florman S., Shapiro R. Racial and Socioeconomic Influences on Kidney Transplantation. A 10 Year Retrospective Study Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Arvelakis A, Lerner S, Wadhera V, Delaney V, Ames S, Shegal V, Kent R, DeBoccardo G, Singh N, Florman S, Shapiro R. Racial and Socioeconomic Influences on Kidney Transplantation. A 10 Year Retrospective Study [abstract]. https://atcmeetingabstracts.com/abstract/racial-and-socioeconomic-influences-on-kidney-transplantation-a-10-year-retrospective-study/. Accessed May 11, 2025.

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