Racial Differences in Determinants of Live Donor Kidney Transplantation in the United States

Overview

Journal Am J Transplant

Publisher Elsevier

Specialty General Surgery

Date 2013 May 15

PMID 23669021

Citations 32

Authors

T S Purnell

P Xu

N Leca

Y N Hall

Affiliations

Soon will be listed here.

Abstract

Few studies have compared determinants of live donor kidney transplantation (LDKT) across all major US racial-ethnic groups. We compared determinants of racial-ethnic differences in LDKT among 208 736 patients who initiated treatment for end-stage kidney disease during 2005-2008. We performed proportional hazards and bootstrap analyses to estimate differences in LDKT attributable to sociodemographic and clinical factors. Mean LDKT rates were lowest among blacks (1.19 per 100 person-years [95% CI: 1.12-1.26]), American Indians/Alaska Natives-AI/ANs (1.40 [1.06-1.84]) and Pacific Islanders (1.10 [0.78-1.84]), intermediate among Hispanics (2.53 [2.39-2.67]) and Asians (3.89 [3.51-4.32]), and highest among whites (6.46 [6.31-6.61]). Compared with whites, the largest proportion of the disparity among blacks (20%) and AI/ANs (29%) was attributed to measures of predialysis care, while the largest proportion among Hispanics (14%) was attributed to health insurance coverage. Contextual poverty accounted for 16%, 4%, 18%, and 6% of the disparity among blacks, Hispanics, AI/ANs and Pacific Islanders but none of the disparity among Asians. In the United States, significant disparities in rates of LDKT persist, but determinants of these disparities vary by race-ethnicity. Efforts to expand preESKD insurance coverage, to improve access to high-quality predialysis care and to overcome socioeconomic barriers are important targets for addressing disparities in LDKT.

Citing Articles

Identifying when racial and ethnic disparities arise along the continuum of transplant care: a national registry study.

Clark-Cutaia M, Menon G, Li Y, Metoyer G, Bowring M, Kim B Lancet Reg Health Am. 2024; 38:100895.

PMID: 39430573 PMC: 11489072. DOI: 10.1016/j.lana.2024.100895.

Components of Residential Neighborhood Deprivation and Their Impact on the Likelihood of Live-Donor and Preemptive Kidney Transplantation.

Li Y, Menon G, Kim B, Clark-Cutaia M, Long J, Metoyer G Clin Transplant. 2024; 38(7):e15382.

PMID: 38973768 PMC: 11232925. DOI: 10.1111/ctr.15382.

Differences in Racial and Ethnic Disparities Between First and Repeat Kidney Transplantation.

Sandal S, Ahn J, Chen Y, Thompson V, Purnell T, Cantarovich M Transplantation. 2024; 108(10):2144-2152.

PMID: 38771099 PMC: 11424272. DOI: 10.1097/TP.0000000000005051.

Disparities Persist Among Hispanic Patients: Completing Evaluation, Waitlisting, and Receiving a Kidney Transplant.

Gordon E, Lee J, Kang R, Uriarte J, Caicedo J Transplant Direct. 2024; 10(3):e1595.

PMID: 38414978 PMC: 10898667. DOI: 10.1097/TXD.0000000000001595.

Expanding Access to Living Donor Kidney Transplants Through Social Networks.

Browne T, Tindall J Kidney Med. 2023; 5(6):100654.

PMID: 37250502 PMC: 10209734. DOI: 10.1016/j.xkme.2023.100654.

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