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Donor and Recipient Ethnicity Impacts Renal Graft Adverse Outcomes

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Renal transplant outcomes have been shown to be impacted by ethnicity. Prior studies have evaluated the disparate transplant outcomes of Black recipients and recipients of Black donors. However, it has remained unclear whether other donor ethnicities independent of medical comorbidities can influence transplant outcomes. Utilizing the Scientific Registry of Transplant Recipients (SRTR) (with greater than 100,000 patients), we evaluated the effect of each ethnicity, Black, American Indian, Hispanic, Native Hawaiian or other Pacific Islander, and Asian as compared to White recipients on adverse kidney transplant outcomes, assessing for delayed graft function, positive urine protein, acute rejection, and graft failure. Additionally, we assessed the interplay of donor ethnicity on recipient transplant outcomes, which has not previously been comprehensively examined. Logistic regression analysis that took into consideration gender, age, comorbidities, graft type, donor ethnicity, body mass index (BMI), HLA mismatch, ever been on hemodialysis, and time on dialysis indicates that Black recipients have worse outcomes compared to Whites in all outcomes assessed. A logistic regression analysis showed that recipient ethnicity was an independent risk factor for adverse outcomes. Notably, we found that donor ethnicity also independently affects graft outcomes. Hispanic donors lead to better outcomes in Whites and Blacks, while Asian donors have the best outcomes amongst Asian recipients. Recipients of Black donors fared the worst of all ethnicity donors. These data suggest the potential importance of risk stratification for the donor allograft and developing risk calculators that include both donor and recipient ethnicity may be useful, which the current Kidney Donor Profile Index (KDPI) does not currently take into account as they give black donors a different weight, but the same score is assigned to Whites, Asians, and Hispanics.

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Abbreviations

BMI:

Body mass index

DGF:

Delayed graft function

SCD:

Standard criteria donor

ECD:

Expanded criteria donor

LD:

Living donor

AR:

Acute rejection

ESRD:

End-stage renal disease

DM2:

Diabetes mellitus type 2

kg:

Kilograms

CAD:

Coronary artery disease

PVD:

Peripheral vascular disease

CI:

Confidence interval

OR:

Odds ratio

CKD:

Chronic kidney disease

GF:

Graft failure

SES:

Socioeconomic status

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Author information

Author notes

  1. Jennifer M. Kwan, Zahraa Hajjiri, David L. Perkins and Patricia W. Finn contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, University of Illinois at Chicago, 909 S Wolcott Ave Room 3060, Chicago, IL, 60612, USA

    Jennifer M. Kwan, Zahraa Hajjiri, David L. Perkins & Patricia W. Finn

  2. Center for Clinical Translational Sciences, University of Illinois at Chicago, Chicago, IL, USA

    Yi Fan Chen

  3. Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA

    Ahmed Metwally & David L. Perkins

  4. Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA

    David L. Perkins

  5. Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, USA

    Patricia W. Finn

Authors
  1. Jennifer M. Kwan
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  2. Zahraa Hajjiri
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  3. Yi Fan Chen
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  4. Ahmed Metwally
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  5. David L. Perkins
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  6. Patricia W. Finn
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Corresponding author

Correspondence to Patricia W. Finn.

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The authors declare that they have no conflict of interest.

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Kwan, J.M., Hajjiri, Z., Chen, Y.F. et al. Donor and Recipient Ethnicity Impacts Renal Graft Adverse Outcomes. J. Racial and Ethnic Health Disparities 5, 1003–1013 (2018). https://doi.org/10.1007/s40615-017-0447-9

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  • DOI: https://doi.org/10.1007/s40615-017-0447-9

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