title: Racial disparities in pediatric kidney transplantation in New Zealand.
abstract: Racial disparities in transplantation rates and outcomes have not been investigated in detail for NZ, a country with unique demographics. We studied a retrospective cohort of 215 patients <18 yr who started renal replacement therapy in NZ 1990-2012, using the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). Primary outcomes were time to first kidney transplant, death-censored graft survival, and retransplantation after loss of primary graft. Europeans and Asians were most likely to receive a transplant (92% and 91% transplanted within five yr, respectively), and Pacific and Māori patients were less likely to receive a transplant than Europeans (51% and 46%, respectively), reflecting disparities in live donor transplantation. Pacific patients were more likely to have glomerulonephritis and FSGS. Pacific patients had five-yr death-censored graft survival of 31%, lower than Māori (61%) and Europeans (88%). No Pacific patients who lost their grafts were re-transplanted within 72 patient-years of follow-up, whereas 14% of Māori patients and 36% of European and Asian patients were retransplanted within five yr. Current programs to improve live and deceased donation within Māori and Pacific people and management of recurrent kidney disease are likely to reduce these disparities.
authors.affiliation: Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), Adelaide, SA, Australia; Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Blair S
authors.initials: BS
authors.lastname: Grace
authors.forename: Tonya
authors.initials: T
authors.lastname: Kara
authors.forename: Sean E
authors.initials: SE
authors.lastname: Kennedy
authors.forename: Stephen P
authors.initials: SP
authors.lastname: McDonald
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000208:ethnology / Q000601:surgery; D005923:Glomerulosclerosis, Focal Segmental / Q000601:surgery; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D009520:New Zealand; D044382:Population Groups; D016016:Proportional Hazards Models; D012042:Registries; D051437:Renal Insufficiency / Q000208:ethnology* / Q000601:surgery*; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome
keywords: Australia and New Zealand Dialysis and Transplant Registry; Māori; Pacific people; live donor; organ donation