title: Indo-Asian experience of renal transplantation in Yorkshire: results of a 10-year survey.
abstract: BACKGROUND
  There is a significant Indo-Asian community in Yorkshire. The rate of end-stage renal failure is disproportionately high in this ethnic group. There have not been any large studies of this ethnic minority's access to and outcome after cadaveric renal transplantation.
  
  
  METHODS
  Three local cohorts were studied: 846 adult patients (9.1% Asian) who started renal replacement therapy 1990-1994, 822 adult patients (11.4% Asian) registered on the transplant waiting list 1985-1994; and 608 adult patients (8.6% Asian) transplanted 1985-1994.
  
  
  RESULTS
  At 1 year from the start of dialysis, 34% of Asian and 31% of non-Asian patients were registered onto the waiting list. After adjustment for age in a multifactorial model, Asian patients were less likely to be listed (relative risk, 0.68), although this did not reach statistical significance (P=0.06). There was a significant difference in graft rate between the groups: at 3 years 72% of non-Asians versus 55% of Asians had been transplanted from the waiting list (P<0.001). For those transplanted, HLA matching was superior for white patients: 34% versus 20% of pairings achieved a 000 mismatched or favorably matched graft (P<0.05). Transplant survival at 5 years was 71% in the non-Asian and 58% in the Asian patients (P=0.07). Asian cadaveric donation was identified in 2 of 608 transplants during a 10-year period.
  
  
  CONCLUSIONS
  Asian patients gained access to the transplant waiting list at a similar rate to the non-Asian white majority. Because of difficulties with HLA matching, Asian patients were significantly disadvantaged in receiving a transplant once listed, and there was a trend towards reduced posttransplant survival. Cadaveric donation was uncommon from within the Asian community; the reasons for which are likely to be complex.
authors.affiliation: St. Luke's Hospital, Bradford, UK.
authors.forename: Robin F
authors.initials: RF
authors.lastname: Jeffrey
authors.forename: Graham
authors.initials: G
authors.lastname: Woodrow
authors.forename: Joanna
authors.initials: J
authors.lastname: Mahler
authors.forename: Rachel
authors.initials: R
authors.lastname: Johnson
authors.forename: Charles G
authors.initials: CG
authors.lastname: Newstead
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D003710:Demography; D004739:England; D005006:Ethnicity; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors; D014850:Waiting Lists; D044465:White People
chemical_list: D000017:ABO Blood-Group System