The Difference in the Impact of Race on Long-Term Graft Survival Between Liver and Kidney Transplantation

Document Type

Conference Proceeding

Publication Date

1-1-2025

Publication Title

Am J Transplant

Abstract

Background: The issue of racial and ethnic disparities in outcomes of liver transplantation (LT) or kidney transplantation (KT) is critical, particularly with increasing diversity. It has been reported that Black has lower graft function than White in both LT and KT. However, the impact of race on long-term outcomes remains unclear. We evaluated and compared the racial influence on very long- term graft survival (GS) in LT and KT. Method: Adult LT or KT alone performed from 2003-2013 were evaluated, using the United Network for Organ Sharing database. To mitigate the prognostic effects of early to mid-term post-transplant complications, we assessed conditional 10-year GS in 5-year survivors post- transplant, which was defined as the probability of GS after 5 years in those who survived for the first 5 years. Race was classified into five categories; White, Black, Hispanic, Asian and Others. The impact of race on GS in each type of transplant was evaluated by Cox proportional hazard model. Result: 71,679 adult LT and 186,342 adult KT were performed from 2003-2013, of which 46,659LT/176,656KT recipients survived at 5 years post-transplantation. Black, white, Hispanic, Asian, and Others LT/KT recipients revealed 10-year conditional GS rates of 80.8%, 81.2%, 84.7%, 88.8%, and 82.2% in LT (p<0.01, Figure 1), and 73.5%, 67.5%, 76.8%, 78.8% and 68.6% in KT, respectively (p<0.01, Figure 2). Black showed significantly lower 10-year conditional GS in KT, compared to White, even after adjusted with age, gender, diabetes mellitus, employment status, educational level and KDPI. (HR1.07, 95%CI 1.03-1.11, p<0.01) In contrast, in LT, Black demonstrated comparable 10-year conditional GS to White after adjusting with age, gender, diabetes mellitus, employment status, educational level and MELD. (HR1.04, 95%CI 0.94-1.15, p=0.45). Conclusion: Black was associated with lower 10-year conditional GS in KT, whereas in LT, 10-year conditional GS between Black and White was comparable when the adverse impact of early to mid-term post-transplant complications was minimized. Further assessment of factors that may drive disparities, such as comorbidities and access to follow-up, is needed to address racial disparities in long-term post-transplant outcomes. [Formula presented] [Formula presented] DISCLOSURES: R. Oki: None. A. Nishimagi: None. I. Rocha: None. S. Al- Juburi: None. L. Rajendran: None. E. Kerby: None. A. Mohamed: None. A. Nassar: None. A. Al-Kurd: None. L. Malinzak: None. J. Denny: None. D. Kim: None. A. Yoshida: None. M. Abouljoud: None. S. Nagai: None.

Volume

25

Issue

1

First Page

S77

Last Page

S78

Find It @ Sladen

Share

COinS