Abstract: FR-PO1036

Impact of Donor Ethnicity on Long-Term Kidney Transplant Outcomes

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Chopra, Bhavna, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
  • Sureshkumar, Kalathil K., Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
Background

African American (AA) ethnicity increases the risk for developing chronic kidney disease (CKD). There is limited data on graft outcomes based on donor ethnicity. Donor ethicity is a variable in the kidney donor profile index (KDPI) designed to aid in organ allocation and in predicting long-term transplant outcomes. We aimed to evaluate long-term kidney transplant outcomes based on donor ethnicity under different KDPI groups.

Methods

Using the OPTN/UNOS database, adult deceased donor kidney (DDK) transplant recipients from 2000 to 2015 who received induction therapy and were discharged on calcineurin inhibitor/ mycophenolate mofetil-based maintenance were identified. Patients were further divided into 4 KDPI categories (0-20%,21-50%,51-85% and >85%). Long term graft and patient outcomes were compared for recipients of AA vs. non-AA donor kidneys under each KDPI group in a multivariate Cox model.

Results

There were 59,648 participants in the study cohort with a median follow up of 48 months. Adjusted graft and patient outcomes among recipients of AA vs.non-AA donor kidneys by KDPI groups are shown in Table 1 and Figure 1. Overall and death-censored graft failure risks were higher for recipeints of AA donor kidneys among higher KDPI (51-85% and >85%) groups but similar among lower KDPI (0-20 and 21-50%) groups. Patient survivals were similar.

Conclusion


Our study showed inferior graft outcomes among recipients of AA donor kidneys in higher KDPI groups despite ethnicity being a variable in deriving KDPI. One could speculate that higher prevalence of risk factors for CKD progression such as APOL1 and sickle cell trait gene mutations among other factors in AA population as contributing to inferior graft outcomes. Prospective studies are needed to further elucidate these findings.

Table 1KDPI 0-20%
AA donor; n=560
Non-AA donor; n=14690
KDPI 21-50%
AA donor; n=2807
Non-AA donor; n=16548
KDPI 51-85%
AA donor; n=2774
Non-AA donor; n=16638
KDPI >85%
AA donor; n=1670
Non-AA donor; n=3961
 HR (95% CI)pHR (95% CI)pHR (95% CI)pHR (95% CI)p
Adjusted overall graft failure risk1.18 (0.99-1.41)0.611.05 (0.95-1.15)0.321.12(1.02-1.20)0.0091.12 (1.04-1.24)0.03
Adjusted death-censored graft failure risk1.19 (0.93-1.50)0.161.11 (0.97-1.25)0.111.12 (1.01-1.25)0.031.33 (1.16-1.51)<0.001
Adjusted patient death risk1.22 (0.99-1.50)0.071.02 (0.91-1.15)0.701.09 (0.99-1.20)0.091.03 (0.91-1.16)0.63