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This Article Full Text Full Text (PDF) Supplemental Data Supplemental Data All Versions of this Article: ASN.2008010078v1 19/10/2011    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Locke, J. E. Articles by Montgomery, R. A. PubMed PubMed Citation Articles by Locke, J. E. Articles by Montgomery, R. A.

Donor Ethnicity Influences Outcomes following Deceased-Donor Kidney Transplantation in Black Recipients

Jayme E. Locke^*, Daniel S. Warren^*, Francesca Dominici, Andrew M. Cameron^*, M. Sue Leffell, Deborah A. McRann^*, J. Keith Melancon^*, Dorry L. Segev^*, Christopher E. Simpkins^*, Andrew L. Singer^*, Andrea A. Zachary and Robert A. Montgomery^*

Departments of ^* Surgery and Medicine, Johns Hopkins Medical Institutions, and Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

Correspondence: Daniel S. Warren, PhD, Department of Surgery, Division of Transplantation, 720 Rutland Avenue, Ross Research Building, Room 765, Baltimore, MD 21205. Phone: 410-614-8297; Fax: 410-614-7649; E-mail: dwarren1{at}jhmi.edu

Received for publication February 6, 2008. Accepted for publication May 7, 2008.

Although the majority of deceased-donor kidneys are donated after brain death, increased recovery of kidneys donated after cardiac death could reduce the organ shortage and is now a national priority. Racial disparities in donations after brain death have been well described for renal transplantation, but it is unknown whether similar disparities occur in donations after cardiac death. In this study, outcomes of adult deceased-donor renal transplant recipients included in the United Network for Organ Sharing database (1993 through 2006) were analyzed. Among black recipients of kidneys obtained after cardiac death, those who received kidneys from black donors had better long-term graft and patient survival than those who received kidneys from white donors. In addition, compared with standard-criteria kidneys from white donors after brain death, kidneys from black donors after cardiac death conferred a 70% reduction in the risk for graft loss (adjusted hazard ratio 0.30; 95% confidence interval 0.14 to 0.65; P = 0.002) and a 59% reduction in risk for death (adjusted hazard ratio 0.41; 95% confidence interval 0.2 to 0.87; P = 0.02) among black recipients. These findings suggest that kidneys obtained from black donors after cardiac death may afford the best long-term survival for black recipients.

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673