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Abstract: FR-PO879

Transplantation Outcome Racial Disparities in Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health


  • McGill, Rita L., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
  • Chapman, Arlene B., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States

Autosomal dominant polycystic kidney disease (ADPKD) patients access to pre-emptive and living donor transplantation varies by race throughout the United States. In this analysis, we examined transplant outcomes by race among patients with ADPKD.


OPTN/UNOS files were used to identify patients age>=30 with ADPKD who received kidney-only transplants. Race was stratified as White (W), African American (AA), Hispanic (H), and Asian (A). Cox models were used to calculate hazard ratios (HR) for graft failure, using (W) as the reference. The model was then adjusted for age, sex, BMI, cold ischemia time, living donation, pre-emptive transplant, diabetes, use of induction therapy, steroid maintenance, and HLA mismatch.


30898 ADPKD transplant recipients were assessed. Patient characteristics are outlined in Table 1. The unadjusted HR for graft failure among AA was 1.55 (1.45, 1.66) P<0.001, and remained 1.30 (1.20, 1.41) P<0.001 after adjustment. Outcome disparities were not observed among H or A patients with ADPKD. (Table 2)


African American ADPKD patients are at higher risk for graft failure after kidney transplant than other patients, above and beyond reduced access to living donor and pre-emptive transplantation. Further work is needed to determine what remediable factors could lead to more equity in transplant outcomes.