Login to Access Video or Poster Abstract: MP30-18
Sources of Funding: None

Introduction

African American (AA) patients have increased rates of end-stage renal disease compared to Caucasian American (CA) patients, and despite making up 13% of the American population, AAs comprise over 30% of the kidney transplantation list. This study seeks to better define our institutional experience in renal transplantation for AA patients in order to identify methods to reduce previously published racial disparities in access to and outcomes after renal transplantation. _x000D_

Methods

We retrospectively reviewed the most recent fifteen years of kidney transplants at our institution. Clinical and demographic characteristics were collected from the electronic medical record. Kaplan Meier curves were generated for patient and graft survival, stratified by race and by living versus deceased donor transplantation._x000D_

Results

A total of 1840 kidney transplants were performed at our institution from 2000-2016, including 1393 CA patients and 447 AA patients. 944 of the transplants were from living donors (LD) and 846 were from deceased donors (DD). Among the 1393 transplants for CAs, 818 (59%) were from LDs, whereas among the 447 AA transplants, only 126 were LD transplants (28%, p<0.001). _x000D_ _x000D_ There was no difference in patient survival between AA and CA recipients of deceased donor recipients or living donor recipients. Graft survival was longer in CA recipients of DD transplants (mean number, p<0.0001) but there was no significance in the graft survival difference between AA and CA recipients of LD transplants (Figure 1). _x000D_

Conclusions

Living donation confers a graft and overall survival advantage compared to DD, and this is true among both AA and CA patients. At our institution there is no significant difference in graft or patient survival between AA and CA patients after living donation, though after deceased donation CAs have improved graft and patient survival. Furthermore, there is a striking difference in utilization of LD transplant between AA and CA patients. This demonstrates the need for further study of why AA patients are severely underrepresented in LD transplants, and improved education and communication regarding living donation among the AA community. _x000D_

Funding

None