Donor Race May Impact Kidney Transplant Survival

"We found that transplant between races had better outcomes than transplant across races," says Anita Patel, M.D., transplant nephrologist at Henry Ford Hospital Transplant Institute and lead author of the study.

"It is important to remember that the statistical difference in this observation is greatly outweighed by the life-giving benefits that recipients get from transplantation."

The study will be presented Oct. 30 at the American Society of Nephrology's Annual Meeting and Scientific Exposition in San Diego by co-investigator Rahul Pandey, M.D., a nephrology fellow.

Using data from the United Network of Organ Sharing (UNOS) of more than 158,000 recipient patients between 1995 and 2008, Henry Ford physicians analyzed the effect of donor/recipient race disparity on patient survival.

By regression analysis, the non-black recipients who received a kidney from black donors had a significant lower survival rate compared to those who received a kidney from a non-black donor (hazard ratio 1.111, p=0.014) after adjusting for all known variables.

"Hepatitis C infection in the donor or recipient was seen as a significant risk factor for mortality," says Dr. Patel.

She further explains that because this is an observation from a large, national database, additional analysis of more detailed, targeted data is needed to determine why the difference exists. Her next step involves looking at the effect of peri-transplant factors, transplant type, socioeconomic status, length of dialysis, immunosuppression regimes and other factors on racial disparity and mortality.

Dr. Patel presented a similar study earlier this year which looked at race and the effect on renal allograft survival in different donor/recipients pairs. In that study, Dr. Patel found an increased risk in graft failure in non-black recipients of non-heart beating black donor kidneys. They appeared to have a two-fold increased risk of graft failure.

According to UNOS, more than 16,000 kidney transplants were performed last year. More than 80,000 people are waiting for kidney donors, and last year, 33,000 new kidney patients joined the registry. Twelve percent of living donors are African-American.