COMPARABLE RENAL GRAFT-SURVIVAL IN AFRICAN-AMERICAN AND CAUCASIAN RECIPIENTS

In past years, many pediatric transplant centers found African-America n renal transplant recipients to have poor graft survival. Since 1991 anti-lymphocyte induction therapy has been routinely used for pediatri c cadaveric (CAD) and living-related donor (LRD) renal allograft recip ients at the University of Tennessee, Memphis. Sixteen African-America n first renal allograft recipients received induction therapy: 11 CAD allografts (10 OKT3, 1 ATGAM) and five LRD (all ATGAM). Sixteen Caucas ian recipients received induction therapy; 3 CAD (all OKT3), 1 living- unrelated donor (OKT3), and 12 LRD (9 ATGAM, 3 OKT3). Mean age at rena l transplantation was 11.8 and 10.5 years for African-American and Cau casian recipients, respectively. Predicted graft survival (PGS) estima ted by the Kaplan-Meier method for the African-American patients was 9 4% at both 1 and 3 years, and for Caucasian patients was 94% and 85% a t 1 and 3 years, respectively. Eleven African-American CAD recipients had a PGS of 91% at 1 and 3 years. Renal allograft survival for Africa n-American and Caucasian pediatric recipients at our center appears to be comparable. This could be due, in part, to the use of anti-lymphoc yte induction therapy. However, other factors, such as improved compli ance or better immunological and pharmacological monitoring, may also have contributed.