End-stage renal disease (ESRD) patients with sickle cell nephropathy (SCN) are less likely to receive a kidney transplant (KT) than ESRD patients without SCN. Comparing patient survival among SCN patients who receive a KT to that of SCN patients who remain on the waitlist for a KT may improve understanding of KT survival benefit in this population.

Methods: Using SRTR data on all US-based adults with SCN who were placed on the KT waitlist between 1998 and 2015, we performed time-dependent Cox regression models with adjustment for patient demographic characteristics to compare relative mortality in candidates who received a KT versus candidates who remained on the waitlist.

Results: There were 540 SCN patients on the KT waitlist, of whom 53.7% were male and 93.1% were black with a mean age of 38.5 years. 24.2% of candidates received a KT. In the first three years post-transplant, mortality in KT recipients was 72% lower than in candidates who remained on the waitlist (aHR: 0.28, 95% CI: 0.12-­0.63, p=0.002). After three years post-transplant, mortality in KT recipients was 55% lower than in candidates who remained on the waitlist (aHR: 0.45, 95% CI: 0.28-­0.72, p=0.001). (Figure 1)

Conclusions: KT is associated with better short and long-term survival in adults with SCN. Efforts to improve timely assessments for transplant-eligibility by nephrologists and to increase rates of KT among SCN patients will help to reduce mortality in this disparity population.

CITATION INFORMATION: Purnell T, Luo X, Bae S, Massie A, Segev D. Survival Benefit of Kidney Transplantation in US Adults with Sickle Cell Nephropathy. Am J Transplant. 2016;16 (suppl 3).

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