title: Racial and Ethnic Disparities in Graft and Recipient Survival in Elderly Kidney Transplant Recipients.
abstract: OBJECTIVE
  To investigate racial and ethnic differences in graft and recipient survival in elderly kidney transplant recipients.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  First-time, kidney-only transplant recipients aged 60 and older of age at transplantation transplanted between July 1996 and October 2010 (N = 44,013).
  
  
  METHODS
  United Network for Organ Sharing (UNOS) database.
  
  
  METHODS
  Time to graft failure and death obtained from the UNOS database and linkage to the Social Security Death Index. Neighborhood poverty from 2000 U.S. Census geographic data.
  
  
  RESULTS
  Of the 44,013 recipients in the sample, 20% were black, 63% non-Hispanic white, 11% Hispanic, 5% Asian, and the rest "other racial groups." In adjusted Cox models, blacks were more likely than whites to experience graft failure (hazard ratio (HR) = 1.23, 95% confidence interval (CI) = 1.15-1.32), whereas Hispanics (HR = 0.77, 95% CI = 0.70-0.85) and Asians (HR = 0.70, 95% CI = 0.61-0.81) were less likely to experience graft failure. Blacks (HR = 0.84, 95% CI = 0.80-0.88), Hispanics (HR = 0.68, 95% CI = 0.64-0.72), and Asians (HR = 0.62, 95% CI = 0.57-0.68) were less likely than whites to die after renal transplantation.
  
  
  CONCLUSIONS
  Elderly blacks are at greater risk of graft failure than white transplant recipients but survive longer after transplantation. Asians have the highest recipient and graft survival, followed by Hispanics. Further studies are needed to assess additional factors affecting graft and recipient survival in elderly adults and to investigate outcomes such as quality of life.
authors.affiliation: Department of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Titilayo O
authors.initials: TO
authors.lastname: Ilori
authors.affiliation: Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia.
authors.forename: Demilade A
authors.initials: DA
authors.lastname: Adedinsewo
authors.affiliation: Department of Radiology, Emory University, Atlanta, Georgia.
authors.forename: Oluwaseun
authors.initials: O
authors.lastname: Odewole
authors.affiliation: Department of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Nosayaba
authors.initials: N
authors.lastname: Enofe
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Akinlolu O
authors.initials: AO
authors.lastname: Ojo
authors.affiliation: Department of Medicine, Emory University, Atlanta, Georgia.|Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: William
authors.initials: W
authors.lastname: McClellan
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, Georgia.|Department of Surgery, School of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Patzer
keywords: elderly; graft survival; kidney transplantation; racial disparities; recipient survival