ETHNIC VARIATIONS IN PATIENT AND GRAFT-SURVIVAL AFTER LIVER-TRANSPLANTATION - IDENTIFICATION OF A NEW RISK FACTOR FOR CHRONIC ALLOGRAFT-REJECTION

The ethnic origin of renal graft recipients is recognized as an import ant determinant of graft survival. In liver transplantation, the effec t of racial origin has been studied in black American recipients and h as suggested a trend toward inferior graft survival in this group. In this study, we have analyzed outcome of transplantation in a large mul tiethnic liver transplant program. Non-Caucasoid recipients had an inf erior patient survival compared with Caucasoids and, in particular, Eu ropean Caucasoids at 1, 3, and 5 years after transplantation (46.7% vs . 60.2% at 3 years, P=0.05). Non-European recipients had an inferior g raft survival compared with European recipients at 1, 2, and 3 years a fter transplantation (e.g., north Europeans 53.5%, south Europeans 48. 5%, Middle Eastern 40%, and non-Caucasoids 27% at 3 years, P<0.01). Di fferent frequencies of chronic allograft rejection in the ethnic group s contributed to the rates of graft survival, with the non-European re cipients developing chronic rejection at over twice the rate of Europe an recipients (12.6% vs. 5.9%, respectively, P=0.002). The findings in this study support the evidence from renal transplant programs that t he ethnic origin of recipients is an important determinant of outcome after transplantation, with increasing frequency of chronic rejection in recipients nonindigenous to the donor population contributing to th e variations in patient and graft survival rates.