Abstract: SA-PO0941
Time-Varying Disparities in Kidney Graft Survival Among Non-Latino, Black, Male Kidney Transplant Recipients
Session Information
- Diversity and Equity in Kidney Health
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Iroegbu, Christin, Towson University, Towson, Maryland, United States
- Kutney-Lee, Ann, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States
- Brooks Carthon, Margo M., University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States
Background
Non-Latino Black male (NLBM) kidney transplant recipients experience higher graft failure rates than other demographic groups. Whether socioeconomic and clinical factors explain how these disparities evolve over time remains unclear.
Methods
We conducted a retrospective cohort study of 133,536 adult kidney transplant recipients (2016–2021) using the Scientific Registry of Transplant Recipients data. Nested Cox models assessed association between NLBM status and graft failure, sequentially adjusting for demographic, socioeconomic, and clinical factors, with standard errors clustered at the transplant center level. Time-dependent effects and adjusted survival curves were evaluated.
Results
Of 133,536 patients, 28,221(17.0%) were NLBM. Median follow-up was shorter among NLBM patients (2.5 years;IQR 1.0-5.1) vs others (2.9 years;IQR 1.0-6.0). Graft failure rates were nearly twice as high in NLBM patients (30.49;95% CI 29.37–31.64) vs others (17.17;95% CI16.81-17.54). NLBM status was associated with higher graft failure risk across all models: demographics (HR =1.75;95% CI 1.65-1.86); socioeconomics (HR=1.64;95% CI 1.54-1.74); and clinical (HR=1.46;95% CI 1.37-1.55; all p<0.001). This disparity increased over time (p < 0.001) with survival curves diverging at approximately three years post-transplant.
Conclusion
NLBM kidney transplant recipients experience a higher graft failure risk, partially explained by socioeconomic and clinical factors. Future research should use qualitative methods and multidimensional social vulnerability measures to identify mechanisms driving disparities and inform equity-oriented interventions.
Acknowledgment
The authors acknowledge Jesse Chittams for his statistical expertise and analytical contributions.
Adjusted graft survival: NLBM recipients vs. all other patients. Inset shows 0.70–1.00 range to visualize differences.
Funding
- Other NIH Support