Effect of donor ethnicity on kidney survival in different recipient pairs: an analysis of the OPTN/UNOS database.
BACKGROUND
Previous multivariate analysis performed between April 1, 1994, and December 31, 2000 from the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) database has shown that kidneys from black donors were associated with lower graft survival. We compared graft and patient survival of different kidney donor-to-recipient ethnic combinations to see if this result still holds on a recent cohort of US kidney transplants.


METHODS
We included 72,495 recipients of deceased and living donor kidney alone transplants from 2001 to 2005. A multivariate Cox regression method was used to analyze the effect of donor-recipient ethnicity on graft and patient survival within 5 years of transplant, and to adjust for the effect of other donor, recipient, and transplant characteristics. Results are presented as hazard ratios (HR) with the 95% confidence limit (CL) and P values.


RESULTS
Adjusted HRs of donor-recipient patient survival were: white to white (1); and white to black (1.22; P = .001). Graft survival HRs were black to black (1.40; P <.001); black to white (1.35; P <.001); black to Hispanic (0.87; P = .18); and black to Asian (0.69; P =.05).


CONCLUSIONS
Black donor kidneys are associated with significantly lower graft survival when transplanted into whites or blacks and are only associated with lower patient survival when these kidneys are transplanted into white recipients. The graft and patient survival rates for Asian and Latino/Hispanic recipients, however, were not affected by donor ethnicity. This analysis underscores the need for research to better understand the reasons for these disparities and how to improve the posttransplant graft survival rates of black kidney recipients.
Callender
C O
CO
Howard University Hospital, 2041 Georgia Ave, NW, Suite 3100, Washington, DC 20060, USA. ccallender@howard.edu
Cherikh
W S
WS
Traverso
P
P
Hernandez
A
A
Oyetunji
T
T
Chang
D
D
D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D002102:Cadaver; D005006:Ethnicity / Q000706:statistics & numerical data; D006085:Graft Survival / Q000502:physiology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D016017:Odds Ratio; D044469:Racial Groups / Q000706:statistics & numerical data; D012044:Regression Analysis; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data