title: Donor ethnicity influences outcomes following deceased-donor kidney transplantation in black recipients.
abstract: Although the majority of deceased-donor kidneys are donated after brain death, increased recovery of kidneys donated after cardiac death could reduce the organ shortage and is now a national priority. Racial disparities in donations after brain death have been well described for renal transplantation, but it is unknown whether similar disparities occur in donations after cardiac death. In this study, outcomes of adult deceased-donor renal transplant recipients included in the United Network for Organ Sharing database (1993 through 2006) were analyzed. Among black recipients of kidneys obtained after cardiac death, those who received kidneys from black donors had better long-term graft and patient survival than those who received kidneys from white donors. In addition, compared with standard-criteria kidneys from white donors after brain death, kidneys from black donors after cardiac death conferred a 70% reduction in the risk for graft loss (adjusted hazard ratio 0.30; 95% confidence interval 0.14 to 0.65; P = 0.002) and a 59% reduction in risk for death (adjusted hazard ratio 0.41; 95% confidence interval 0.2 to 0.87; P = 0.02) among black recipients. These findings suggest that kidneys obtained from black donors after cardiac death may afford the best long-term survival for black recipients.
authors.affiliation: Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.
authors.forename: Jayme E
authors.initials: JE
authors.lastname: Locke
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Warren
authors.forename: Francesca
authors.initials: F
authors.lastname: Dominici
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Cameron
authors.forename: M Sue
authors.initials: MS
authors.lastname: Leffell
authors.forename: Deborah A
authors.initials: DA
authors.lastname: McRann
authors.forename: J Keith
authors.initials: JK
authors.lastname: Melancon
authors.forename: Dorry L
authors.initials: DL
authors.lastname: Segev
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Simpkins
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Singer
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Zachary
authors.forename: Robert A
authors.initials: RA
authors.lastname: Montgomery
mesh_terms: D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D002102:Cadaver; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D007674:Kidney Diseases / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data*