title: Outcome disparities between African Americans and Caucasians in contemporary kidney transplant recipients.
abstract: BACKGROUND
  Racial disparities in African-American (AA) kidney transplant have persisted for nearly 40 years, with limited data available on the scope of this issue in the contemporary era of transplantation.
  
  
  METHODS
  Descriptive retrospective cohort study of US registry data including adult solitary kidney transplants between Jan 1, 2005 to Dec 31, 2009.
  
  
  RESULTS
  60,695 recipients were included; 41,426 Caucasians (68%) and 19,269 AAs (32%). At baseline, AAs were younger, had lower college graduation rates, were more likely to be receiving public health insurance and have diabetes. At one-year post-transplant, AAs had 62% higher risk of graft loss (RR 1.62, 95% CI 1.50-1.75) which increased to 93% at five years (RR 1.93, 95% CI 1.85-2.01). Adjusted risk of graft loss, accounting for baseline characteristics, was 60% higher in AAs (HR 1.61 [1.52-1.69]). AAs had significantly higher risk of acute rejection and delayed graft function.
  
  
  CONCLUSIONS
  AAs continue to experience disproportionately high rates of graft loss within the contemporary era of transplant, which are related to a convergence of an array of socioeconomic and biologic risk factors.
authors.affiliation: Division of Transplant Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA. Electronic address: taberd@musc.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Taber
authors.affiliation: Center for Health Disparities Research, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
authors.affiliation: Division of Transplant Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Prabhakar K
authors.initials: PK
authors.lastname: Baliga
mesh_terms: D001741:Black or African American; D017677:Age Distribution; D015992:Body Mass Index; D015331:Cohort Studies; D003404:Creatinine / Q000032:analysis; D051799:Delayed Graft Function / Q000208:ethnology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006084:Graft Rejection / Q000208:ethnology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016030:Kidney Transplantation; D008297:Male; D008483:Medical Assistance; D008875:Middle Aged; D012189:Retrospective Studies; D066027:Transplant Recipients; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D003404:Creatinine
keywords: Acute rejection; African Americans; Graft loss; Kidney transplant