RACE EFFECT IN LIVING-RELATED DONOR KIDNEY TRANSPLANTS

Résumé fourni par la source

495 Although much has been written about the effect of race on renal graft survival in cadaver renal transplants, the effect of race on outcome in living-related donor transplants (LRD) is not well documented. The purpose of this study is to compare patterns of donation and outcomes in Caucasian (C) and African-American (AA) patients who undergo an LRD. Between 1/3/90 and 9/26/98, 546 renal transplants were performed at our center, 187 of which were LRD. The proportion of LRD/total transplants was 124/309=40% in C compared to 63/237=26% in AA (P=0.001). When comparing 1990-92 vs 1993-95 vs 1996-98, a more dramatic increase in the proportion of LRD/total transplants was observed in AA (14% vs 25% vs 48%, P<0.0005) compared to C (40%, 41% and 59%, P=0.02). C and AA were comparable with respect to: donor (age, gender) and recipient demographics (age, gender, % PRA, % diabetic, HLA mismatch and body mass index). The following characteristics differed (C vs AA): Pre-dialysis (35% vs 17%, P=0.01), median duration of pre-transplant dialysis (251 vs 381 days, P=0.001), antibody induction (9% vs 32%, P<0.0005) and donor type (see table).TableIn conclusion, compared to C, AA was associated with: (1) a more impressive increase in LRD/total transplants between 1990 and 1998, (2) a different pattern of donor type with a lower rate of sibling donors and a higher rate of parent and offspring donors, (2) fewer pre-dialysis patients, (3) higher serum creatinine levels days 0 to 7, (4) more frequent primary and recurrent acute rejection episodes, (5) a longer length of stay and (6) a lower uncensored graft survival rate.

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