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Author Notes:

Corresponding author: Rachel E. Patzer, rpatzer@emory.edu

The interpretation and reporting of the data presented here are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US government.

We would like to acknowledge Paul Eggers, PhD, and Rebecca Zhang, MS, for assistance in USRDS data acquisition.

A portion of this work was presented as free communication at the American Transplant Congress 2010 Annual Meeting (San Diego, CA, USA): Am J Transplantation 10, Suppl 4: 73. Abstract #113.

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.



  • Access to transplantation
  • health insurance
  • kidney transplant waiting list
  • neighborhood poverty
  • pediatric kidney transplantation
  • racial and ethnic disparities
  • United States Renal Data System

Racial Disparities in Pediatric Access to Kidney Transplantation: Does Socioeconomic Status Play a Role?


Journal Title:

American Journal of Transplantation


Volume 12, Number 2


, Pages 369-378

Type of Work:

Article | Post-print: After Peer Review


Racial disparities persist in access to renal transplantation in the United States, but the degree to which patient and neighborhood socioeconomic status (SES) impacts racial disparities in deceased donor renal transplantation access has not been examined in the pediatric and adolescent end-stage renal disease (ESRD) population. We examined the interplay of race and SES in a population-based cohort of all incident pediatric ESRD patients <21 years from the United States Renal Data System from 2000 to 2008, followed through September 2009. Of 8 452 patients included, 30.8%were black, 27.6% white-Hispanic, 44.3% female and 28.0% lived in poor neighborhoods. A total of 63.4% of the study population was placed on the waiting list and 32.5% received a deceased donor transplant. Racial disparities persisted in transplant even after adjustment for SES, where minorities were less likely to receive a transplant compared to whites, and this disparity was more pronounced among patients 18–20 years. Disparities in access to the waiting list were mitigated in Hispanic patients with private health insurance. Our study suggests that racial disparities in transplant access worsen as pediatric patients transition into young adulthood, and that SES does not explain all of the racial differences in access to kidney transplantation.

Copyright information:

© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons

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