Temporal Trends in the Influence of Socioeconomic Factors on Kidney Transplant Outcomes

Document Type

Conference Proceeding

Publication Date

8-2-2025

Publication Title

Am J Transplant

Abstract

Purpose: Socioeconomic status is widely recognized as a factor influencing graft survival (GS) in adult kidney transplant (KT) recipients. We hypothesized that the influence of socioeconomic status on GS varies across different post-transplantation periods. We evaluated the longitudinal impact of socioeconomic status on GS over time. Methods: Adult KT alone performed from 2003-2013 were evaluated using the United Network for Organ Sharing database. The period of post-transplantation was divided into 3 categories; Group1: 1-year survival in all patients, Group2: conditional 5-year survival in 1 year-survivors, Group3: conditional 10-year survival in 5-year survivors (Fig.1). Socioeconomic factors included patient education level, employment status at transplant and distance from transplant center to patient residence at transplant. The impact of socioeconomic factors on graft survival in each period was evaluated using the Cox proportional hazards model, stratified by deceased and living donor KT. Results: In total, 186,342 adult KT were performed from 2003-2013 (Group1), of which 176,656 recipients survived at 1 year (Group2) and 126,405 recipients survived at 5 years (Group3) post-transplant. Multivariable Cox hazard model revealed that employment status at transplant was independently associated with better graft survival in all groups in both deceased (Fig.2) and living (Fig.3) KT. While lower education level (high school or lower, reference; postcollege graduate degree) was not the risk factor in Group1, it increased the risk of graft failure in the later periods for both deceased donor and living donor KT. There was no association between the distance and patient outcomes in all groups. Conclusions: The impact of socioeconomic status on GS changed over time in both living and deceased KT.To improve the very long-term outcomes in later periods, consideration of the patient's education level in follow-up care might be necessary. [Formula presented] [Formula presented] [Formula presented] CITATION INFORMATION: Al-Juburi S., Oki R., Rocha I., Rajendran L., Kerby E., Mohamed A., Nassar A., Al-Kurd A., Kim D., Yoshida A., Abouljoud M., Nagai S. Temporal Trends in the Influence of Socioeconomic Factors on Kidney Transplant Outcomes AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: S. Al-Juburi: None.

Volume

25

Issue

8

First Page

S890

Last Page

S891

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