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Abstract: TH-OR58

Living in High Minority, Less English-Proficient Communities May Facilitate Living Donor Kidney Transplantation Among Asian Americans and Pacific Islanders

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Killian, Alixandra Cozette Kale, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Shelton, Brittany A., University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Maclennan, Paul A., University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Mcleod, Marshall Chandler, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Carter, Alexis J., University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Reed, Rhiannon D., University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Qu, Haiyan, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Orandi, Babak J., University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Kumar, Vineeta, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Sawinski, Deirdre L., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Locke, Jayme E., University of Alabama at Birmingham, Birmingham, Alabama, United States
Background

Living donor kidney transplantation (LDKT) racial disparities have increased. Living in linguistically isolated communities or areas with large minority populations has been associated with decreased access to transplant, but LDKT recipient-donor pairs are 95% racially concordant. The contemporary relationship between LDKT access and living in high minority, less English proficient communities is unknown.

Methods

The Scientific Registry of Transplant Recipients was utilized to identify adult, kidney-only transplant recipients (1/1/2018-12/31/2018). The Minority Status and Language Theme of the Centers for Disease Control and Prevention 2018 Social Vulnerability Index was linked to recipients’ zip codes. Modified Poisson regression was utilized to evaluate likelihood of LDKT.

Results

Of the 18,950 kidney transplant recipients included in this study, 32% achieved LDKT. Black (adjusted relative risk (aRR): 0.60, 95% confidence interval (CI): 0.49-0.74) and Asian American and Pacific Islander (AAPI) recipients (aRR: 0.52, 95%CI: 0.39-0.70) were less likely to receive LDKT compared to White recipients. Overall, community minority status and language proficiency was not associated with LDKT (aRR: 1.01, 95%CI: 1.00-1.02), but the effect of this vulnerability measure varied by race. Among AAPI recipients only, living in higher minority, less English proficient communities was associated with increased likelihood of LDKT (ratio of aRR: 1.66, 95%CI: 1.12-2.47; Figure 1).

Conclusion

While all minority recipients had lower likelihood of LDKT, living in higher minority, less English proficient communities may be paradoxically advantageous for AAPI patients. Given LDKT racial concordance, living in areas with shared culture or language may facilitate LDKT access among AAPI.

Funding

  • NIDDK Support