Date: Sunday, June 12, 2016
Session Name: Poster Session B: Disparities in Access and Outcomes
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Previous studies have shown that Native Americans (NAs) have decreased access and inferior outcomes following kidney transplantation. Reviewing our center's experience we wanted to assess the differences in kidney transplant access and outcomes for NAs compared to other racial groups.
We included all kidney transplants done between 7/2003 and 4/2015 excluding multiorgans. Immunosuppression employing rATG, alemtuzumab or basiliximab for induction with tacrolimus and MMF for maintenance with or without steroids depending on age and immunologic risk. Demographic, clinical and pathologic data were collected throughout the follow up period. Surveillance biopsies were done at 4 month, 1 and 2 years and rejection was defined by the Banff 97 criteria and included clinical and subclinical episodes. eGFR was calculated using the CKD-EPI formula. Median follow up for NAs was similar to the other races and was through 10/2015.
2048 kidney transplants were done in the period. 186 (9%)recipients were NAs, 7% African Americans, 15% Hispanics, 1.4% Asians, 63% Caucasians and 3.8% others.
|Native Americans n=186||Other Racial Groups n=1862||p|
|Age at transplant||51.1±12.5||53.6±13.7||.014|
|Wait Time days||825±787||548±552||<.001|
|eGFR 1 yr||65±21||59±20||.001|
There were no differences in donor age, race, recipient gender, chronic changes at 1 year and CMV/BK infections. Basiliximab induction was less in NAs likely reflecting the groups younger age.
Conclusion: Despite longer wait on dialysis and lower living donation rates, Native Americans exhibit similar patient and allograft survival compared to other racial groups with similar rejection and infection rates.
CITATION INFORMATION: Khamash H, Reddy K, Chakkera H, Huskey J, Sukumaran-Nair S, Mathur A, Moss A, Katariya N, Singer A, Heilman R. Similar Kidney Allograft and Patient Survival in Native Americans Despite Lower Rates of Living Donation and Longer Wait on the Deceased Donor List. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Khamash H, Reddy K, Chakkera H, Huskey J, Sukumaran-Nair S, Mathur A, Moss A, Katariya N, Singer A, Heilman R. Similar Kidney Allograft and Patient Survival in Native Americans Despite Lower Rates of Living Donation and Longer Wait on the Deceased Donor List. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/similar-kidney-allograft-and-patient-survival-in-native-americans-despite-lower-rates-of-living-donation-and-longer-wait-on-the-deceased-donor-list/. Accessed March 3, 2021.
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