Renal transplantation in Indo-Asian patients in the UK.
Membership of some ethnic groups has an effect on renal transplant outcome but little is known about the impact of Indo-Asian ethnicity, despite this group's high incidence of renal disease. We compared outcomes in Indo-Asians and Caucasians at the Hammersmith Hospital (Indo-Asians, N = 46; Caucasians, N = 90), in the Long-Term Efficacy and Safety Surveillance (LOTESS) database of cyclosporin-treated renal transplant recipients (Indo-Asians, N = 254; Caucasians, N = 4262) and the National Transplant Database held by UK Transplant (Indo-Asians, N = 459; Caucasians, N = 4831). The baseline demographic and co-morbid characteristics of the two ethnic groups were comparable, save for more diabetes in the Indo-Asian community. Following transplantation, the incidence of delayed graft function and steroid-resistant acute rejection were also comparable, as were graft and patient survival (out to 5 years) and graft function. In addition, post-transplant blood pressure, levels of cholesterol and triglycerides and exposure to corticosteroids and cyclosporin were comparable. However, when patients who were not diabetic before transplantation were studied separately, there was an increased incidence of diabetes in the Indo-Asian community (Hammersmith data: Indo-Asians 10.9% vs. Caucasians 3.3%, p = 0.02; LOTESS data Indo-Asians 5.5% vs. Caucasians 1.6%, p < 0.0001). Subsequent management of this group should pursue immunosuppressive regimens less likely to impair post-transplant glucose tolerance.
Department of Immunology, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK.
M D
MD
Dooldeniya
P J
PJ
Dupont
X
X
He
R J
RJ
Johnson
T
T
Joshi
R
R
Basra
A
A
Johnston
A N
AN
Warrens
D000328:Adult; D001211:Asia, Western / Q000208:ethnology; D044466:Asian People; D051799:Delayed Graft Function / Q000208:ethnology* / Q000401:mortality; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D006084:Graft Rejection / Q000208:ethnology* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000208:ethnology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D006113:United Kingdom / Q000453:epidemiology; D044465:White People