Racial disparities in renal transplant outcomes

The purpose of our study was to evaluate the association of race and ethnic ity with outcomes in the living related donor (LRD) renal transplant popula tion, using multivariable adjustment for potential confounding variables. W e prospectively analyzed 14,617 patients from the UNOS Renal Transplant Reg istry who underwent LRD renal transplantations in the United States between January 1, 1988 and December 31, 1996 using the Cox proportional hazards m odel, This model adjusts for the effects of potential genetic, social, and demographic confounding variables that may be associated with race or ethni city long-term graft survival. Blacks were 1,8 times as likely as whites (P < 0,01, RR = 1.77) to suffer graft failure during the g-year study period, which decreased minimally to 1,7 (P < 0.01, RR = 1.65) after controlling f or potential confounding variables. Neither genotypic nor phenotypic HLA ma tching improved outcomes in blacks. Black renal transplant recipients had l ower graft survival even after adjustment for matching and rejection, sugge sting that non-HLA or socioeconomic mechanisms may contribute to racial dif ferences in transplantation outcomes. (C) 1999 by the National Kidney Found ation, Inc.