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Author Notes:

Corresponding author: Titilayo O. Ilori, M.D, Renal Division, Emory University School of Medicine, 1639 Pierce Drive, Atlanta GA. Clifton Road, Atlanta Georgia 30322 (tilori@emory.edu).

Titilayo O. Ilori, William McClellan and Rachel Patzer designed the research study.

Titilayo O. Ilori was responsible for writing the manuscript and had full access to all of the data in the study and takes primary responsibility for the integrity of the data, accuracy of the data analysis and final content of the manuscript.

Demilade Adedinsewo, Nosayaba Enofe and Titilayo O. Ilori performed the data analysis; Demilade Adedinsewo, Oluwaseun Odewole, Nosayaba Enofe, Akinlolu Ojo, William McClellan and Rachel Patzer participated in writing the manuscript.

All authors read and approved the final manuscript for submission.

Special thanks to Dr. Laura Plantinga for proof-reading the manuscript.

The authors declare no competing interests.

Subjects:

Research Funding:

Titilayo O. Ilori receives educational support from the ACTSI.

This study was supported in part from divisional funds of the Department of Nephrology, Emory University Atlanta GA.

This publication was also supported in part by the National Heart, Lung, Blood and Sleep Institute, National Institutes of Health, through Grant Number R25 HL105401.

REP is supported in part by the National Institute of Minority Health and Health Disparities (R24MD008077).

This work was supported in part by Health Resources and Services Administration contract 234-2005-370011C.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Geriatrics & Gerontology
  • Gerontology
  • elderly
  • racial disparities
  • recipient survival
  • graft survival
  • kidney transplantation
  • RENAL-ALLOGRAFT SURVIVAL
  • SOLID-ORGAN TRANSPLANTATION
  • PUBLIC-HEALTH ISSUE
  • UNITED-STATES
  • SOCIOECONOMIC-STATUS
  • AFRICAN-AMERICANS
  • HISPANIC PARADOX
  • OUTCOMES
  • EXPERIENCE

Racial and Ethnic Disparities in Graft and Recipient Survival in Elderly Kidney Transplant Recipients

Tools:

Journal Title:

Journal of the American Geriatrics Society

Volume:

Volume 63, Number 12

Publisher:

, Pages 2485-2493

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background/Objectives: The rise in the number of elderly kidney transplant recipients over the past decade makes it increasingly important to understand factors affecting post-transplant outcomes in this population. Our objective was to investigate the racial/ethnic differences in graft and patient survival among elderly kidney transplant recipients. Design: Retrospective Cohort. Setting & Participants: All first-time, kidney-only transplant recipients ≥60 years of age at transplantation in the United Network for Organ Sharing (UNOS) database, transplanted between July 1996 and October 2010, N=44,013. Measurements: 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 African American, 63% non-Hispanic white, 11% Hispanic, 5% Asian and the rest “other racial groups”. In adjusted Cox models, we found that compared to whites, African Americans were more likely to experience graft failure (HR: 1.23, 95%CI: 1.15, 1.32), while 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. Secondly, compared to whites, African Americans (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) all were less likely to die after renal transplantation. Conclusion: Elderly African Americans are at increased risk of graft failure compared to white transplant recipients, but survive longer after transplantation. Asians have the highest patient and graft survival followed by the Hispanics. Further studies are needed to assess additional factors affecting graft and patient survival including outcomes such as quality of life.

Copyright information:

© 2015, the Authors. Journal compilation © 2015, The American Geriatrics Society

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