Racial Differences in Acceptance of Public Health Service (PHS) Increased Risk Kidneys and Hepatitis C (HCV) Nat Positive Kidneys
Tulane University, New Orleans, LA
Meeting: 2020 American Transplant Congress
Abstract number: 16
Keywords: Hepatitis C, Kidney transplantation
Session Information
Date: Saturday, May 30, 2020
Session Name: Kidney Deceased Donor Allocation I
Session Time: 3:15pm-4:45pm
Presentation Time: 4:03pm-4:15pm
Location: Virtual
*Purpose: PHS increased risk kidneys and HCV NAT positive kidneys represent a significant proportion of the donor pool however, acceptance demands explicit patient consent that may be affected by racial bias.
*Methods: We examine racial differences in the acceptance of PHS increased risk and HCV NAT positive kidneys using national data in the KAS era
*Results: 47803 adult patients who received a deceased donor kidney only (multiorgan excluded) for the first time (12/5/2014 to 6/1/2019) met inclusion criteria. 16603 (35%) were white, 17032 (36%) were black, 9262 (19%) were Hispanic, 3683 (8%) were Asian and 1223 (3%) constituted other. Of transplanted kidneys, 12162 (25%) were PHS increased risk and 1641 (3%) were HCV NAT positive. 45112 recipients were HCV seronegative and 2691 recipients were HCV seropositive. Among those seropositive, 926 (34%) received a NAT positive kidney. Of these 926 kidneys, 60% were transplanted in black recipients and 23 % in white recipients. Among seronegative patients, 715 (2%) received a NAT positive kidney. Of these 715 kidneys, 45% were transplanted in white recipients and 40% in black recipients. In multivariable logistic models adjusting for recipient and donor factors (ABO, HLA mismatch CPRA and waiting time donor age,height, weight and race) OR for acceptance of a PHS increased risk kidney was 1.1 (95% CI 1.04-1.17 p <.0001 ) for black recipients vs white. For acceptance of a HCV NAT positive kidney among seropositive recipients there was no difference in acceptance black v white OR 1.3 (95% CI 0.9-1.7 p =0.3220). Among seronegative recipients, acceptance was increased for black v white OR 1.7 (95% CI 1.3-1.9 p <.0001) .
*Conclusions: Despite similar acceptance for PHS increased kidneys, black recipients have an increased odds of receiving a HCV NAT positive kidney if the recipient is seronegative compared to whites. Perhaps HCV NAT positive kidneys are offered more readily to black patients or conversely accepted more readily by black patients.
To cite this abstract in AMA style:
Atiemo K, Giusti S, Paramesh A, Killackey M, Jeon H. Racial Differences in Acceptance of Public Health Service (PHS) Increased Risk Kidneys and Hepatitis C (HCV) Nat Positive Kidneys [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/racial-differences-in-acceptance-of-public-health-service-phs-increased-risk-kidneys-and-hepatitis-c-hcv-nat-positive-kidneys/. Accessed January 25, 2021.« Back to 2020 American Transplant Congress