Access and outcomes among minority transplant patients, 1999-2008, with a focus on determinants of kidney graft survival.

Academic Article

Abstract

  • Coincident with an increasing national interest in equitable health care, a number of studies have described disparities in access to solid organ transplantation for minority patients. In contrast, relatively little is known about differences in posttransplant outcomes between patients of specific racial and ethnic populations. In this paper, we review trends in access to solid organ transplantation and posttransplant outcomes by organ type, race and ethnicity. In addition, we present an analysis of categories of factors that contribute to the racial/ethnic variation seen in kidney transplant outcomes. Disparities in minority access to transplantation among wait-listed candidates are improving, but persist for those awaiting kidney, simultaneous kidney and pancreas and intestine transplantation. In general, graft and patient survival among recipients of solid organ transplants is highest for Asians and Hispanic/Latinos, intermediate for whites and lowest for African Americans. Although much of the difference in outcomes between racial/ethnic groups can be accounted for by adjusting for patient characteristics, important observed differences remain. Age and duration of pretransplant dialysis exposure emerge as the most important determinants of survival in an investigation of the relative impact of center-related versus patient-related variables on kidney graft outcomes.
  • Authors

    Published In

    Keywords

  • African Americans, Asian Continental Ancestry Group, Continental Population Groups, Ethnic Groups, European Continental Ancestry Group, Graft Survival, Hispanic Americans, Humans, Kidney, Kidney Transplantation, Minority Groups, Renal Dialysis, Treatment Outcome
  • Digital Object Identifier (doi)

    Author List

  • Fan P-Y; Ashby VB; Fuller DS; Boulware LE; Kao A; Norman SP; Randall HB; Young C; Kalbfleisch JD; Leichtman AB
  • Start Page

  • 1090
  • End Page

  • 1107
  • Volume

  • 10
  • Issue

  • 4 Pt 2