2032
Effect of Donor Ethnicity on Kidney Allograft Survival in Live Donor Transplantation
Konstantinos Koutroutsos, Rawya Charif, Dimitrios Mountzouris, Jack Galliford, Phillipa Dodd, David Taube,Marina Loucaidou
Imperial College Kidney and Transplant Centre, London, UK
Background: Studies in the United States have shown that kidneys donated by Americans of African Origin (AO) are known to function for shorter periods of time and this effect is observed whether kidneys are transplanted into AO or non-AO recipients. Limited data exist on the effect of transplantation from AO donors to kidney allograft survival in European populations.
Methods: We retrospectively reviewed the medical records of 545 kidney live donor transplant recipients in our centre between November 2005 and December 2012 (336 male, mean age:47.4+/-12.8 years). 481patients (300 male, mean age: 47.4+/-12.8 years) were included in the study cohort, after excluding paired pooled (n=14), altruistic transplants (n=9), mixed race donors (n=8)and pairs for which donor data were not available (n=33).
Results:Out of 481 pairs studied, 219 (45.5%) had a live unrelated, while 262(54.5%) a live related transplant. 59 (12.3%) of the transplants were ABO incompatible. Mean follow up of the patients was 46.19 (+/-24.5) months. There was no difference in patient survival between different racial groups at 1 (Asian: 98.4%vs.AO: 100%vs. Caucasian: 99%) and 5 years (Asian: 91.2% vs. Black: 93% vs. Caucasian: 91.7%) post transplantation. (p=0.6) Censored allograft survival was found to be lower in the patients that received a graft from AO donors (91.3% and 73.1% at 1 and 5 years) when compared to the ones from Asian (93.5% and 85%% at 1 and 5 years), or Caucasian donors (97% and 88.3%% at 1 and 5 years). (p=0.03) A multivariate Cox regression model, adjusted for differences in donor and recipient sex, age, recipient race, type of transplant (LURT / LRT, ABOi), time post-transplant, cause of ESRD, and induction immunosuppressant medications, revealed a significantly increased risk for graft loss for recipients with a graft from anAO donor compared to all other races. (HR: 3.51, 95%CI: 0.11-0.77, p=0.014)
Graph1: Censored allograft survival according to Donor race:
2032
Conclusion: This study confirms that patients receiving kidneys from donors of AO face an increased risk for reduced graft survivalin a UK population. Further studies are required to clarify the causes of this racial disparity in kidney allograft outcomes.