EFFECT OF RACE ON OUTCOME FOLLOWING KIDNEY AND KIDNEY-PANCREAS TRANSPLANTATION IN TYPE-I DIABETICS - THE SOUTH-EASTERN ORGAN PROCUREMENT FOUNDATION EXPERIENCE

In this study we analyze the South-Eastern Organ Procurement Foundatio n (SEOPF) experience with kidney and kidney-pancreas transplantation i n IDDM recipients and evaluate the impact of racial disparity on patie nt and graft outcome. Data obtained from 4413 kidney-alone and 884 pan creas transplants performed in White and Black type I diabetics at mem ber institutions of SEOPF between 10/1/87 and 7/25/96 were analyzed. S urvival data from 15,827 transplants performed during the same period of time in non-diabetics were available for comparison. A lesser propo rtion of pancreas recipients were Black compared to kidney-alone (12% vs 23%, p<0.0005). Recipient race had no effect on patient survival in any of the groups studied. Kidney graft survival, on the other hand, was adversely affected by Black race in both non-diabetic and diabetic recipients of a kidney transplant but not in diabetics who received a combined pancreas-kidney transplant. As was the case for patient surv ival in diabetics, recipient race had no effect on pancreas graft surv ival. Cox Regression analysis showed that kidney-pancreas transplant ( p=0.034, RR=0.49) and female recipient gender (p=0.046, RR=0.68) were associated with a lower risk of failure of the pancreas graft. The fol lowing factors were independent predictors of kidney graft outcome: Do nor age (p=0.0001, RR=0.95), kidney-pancreas transplant (p=0.0004, RR= 0.58), AB match (p=0.001, RR=0.86), DR match (p=0.006, RR=0.82), prese rvation time (p=0.012, RR=1.01), Black recipient race (p=0.047, RR=1.2 3) and living donor (p=0.06, RR=0.73). Our findings suggest that the e ffect of race on graft outcome observed in non-diabetic and, to a less er extent, diabetic kidney-alone transplant recipients, is not present after kidney-pancreas transplantation.