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Abstract: SA-PO1065

Longitudinal Changes in the Effect of Socioeconomic Status on Graft Survival in Kidney Transplantation

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Oki, Rikako, Henry Ford Hospital, Detroit, Michigan, United States
  • Khoury, Nadeen J., Henry Ford Hospital, Detroit, Michigan, United States
  • Patel, Anita K., Henry Ford Hospital, Detroit, Michigan, United States
  • Shrivastava, Pritika, Henry Ford Hospital, Detroit, Michigan, United States
  • Prashar, Rohini, Henry Ford Hospital, Detroit, Michigan, United States
  • Nagai, Shunji, Henry Ford Hospital, Detroit, Michigan, United States
Background

Socioeconomic status is recognized as a factor influencing graft survival (GS) in kidney transplant (KT). We evaluated the longitudinal impact of socioeconomic status on GS.

Methods

Adult KT alone performed from 2003-2013 were evaluated using the United Network for Organ Sharing database. The period of post-transplantation was divided into 3 categories; Group1: 1-year survival in all patients, Group2: conditional 5-year survival in 1 year-survivors, Group3: conditional 10-year survival in 5-year survivors. We explored the influence of socioeconomic status on long-term GS in living donor KT (LDKT) and deceased donor KT (DDKT), focusing on two domains: (1) area-level factors, defined by the area deprivation index (ADI); and (2) individual-level factors, including patients’ income, education level.

Results

In total, 186,342 adult KT were performed from 2003-2013 (Group1), of which 176,656 recipients survived at 1 year (Group2) and 126,405 recipients survived at 5 years (Group3) post-transplant. In DDKT, the most deprived area (ADI 71-100) was associated with worse GS only in the latest period, compared to the least deprived area (ADI 0-25). In contrast, in LDKT, patients residing in the most deprived areas was linked to poorer GS across all post-transplant periods(Fig.1). Lower education level was associated with worse GS only in the later post-transplant period for both DDKT and LDKT, while employment at the time of transplant was associated with better outcomes throughout (Fig.2).

Conclusion

The impact of socioeconomic status on GS changed over time in both DDKT and LDKT. To improve the long-term outcomes, consideration of the education level and areas of residence might be necessary.

Digital Object Identifier (DOI)