THE ADMISSION OF ASIAN PATIENTS TO INTENSIVE THERAPY UNITS AND ITS IMPLICATIONS FOR KIDNEY DONATION - A PRELIMINARY-REPORT FROM COVENTRY, UK

Objective - To determine the relative admission rates of Asian and non -Asian patients to intensive therapy units (ITUs) in Coventry and to e xplore the implications of these rates for the transplantation of orga ns to Asian people. Design - Examination of 1991 census data and a ret rospective review of ITU admissions books. Data were collected on ethn ic background, presenting diagnosis, and clinical outcome for each adm ission. Setting - The three ITUs in Coventry. Patients - All admission s to the ITUs from 1990-93 inclusive. Results - Asian patients were ad mitted to ITUs disproportionately to their numbers in the Coventry pop ulation. Members of the Asian community were less than half as likely to be admitted to an ITU (p < 0.001) and more likely to die while ther e (p=0.007) than members of the non-Asian population in Coventry. The proportions of patients referred to the transplant unit and the rates of subsequent donation do not seem to differ significantly for Asian a nd non-Asian patients (p=0.26 in both cases). Conclusions - There are clear implications for the availability of cadaveric kidney transplant ation to Asian patients, given that few kidneys from non-Asian donors are histocompatible with Asian recipients. Indeed, in Asians, promotio n of living related donation may be more effective in countering the o rgan shortfalll than efforts to increase consent to cadaveric transpla ntation. However, it may be valuable to investigate any patterns of mo rbidity or social or cultural factors that might explain the initial l ow admissions rates to ITUs for Asian patients.