Long-Term Conditional Graft Survival in Liver and Kidney Transplants: Does Race Matter Differently?
Recommended Citation
Rocha I, Oki R, Nishimagi A, Al-Juburi S, Rajendran L, Kerby E, Mohamed A, Nassar A, Al-Kurd A, Kim D, Yoshida A, Abouljoud M, Nagai S. Long-Term Conditional Graft Survival in Liver and Kidney Transplants: Does Race Matter Differently?. Am J Transplant 2025; 25(8):S277.
Document Type
Conference Proceeding
Publication Date
8-1-2025
Publication Title
Am J Transplant
Abstract
Purpose: Racial and ethnic disparities in outcomes after liver transplantation (LT) and kidney transplantation (KT) are important to address. Previous studies showed that Black has lower graft survival (GS) than White in both LT and KT. However, it remains unclear about the impact of race on very long-term post-transplant outcomes. This study aimed to evaluate and compare the influence of race on very long-term GS in LT and KT. Methods: Adult LT or KT performed from 2003-2013 were evaluated respectively, using the United Network for Organ Sharing database. To mitigate the prognostic effects of early post-transplant complications, we assessed conditional 10-year GS in 5-year graft survivors post-transplant,defined as the probability of GS at 10 years after 5 years in those whose graft function was maintained during the first 5 years. Race was classified into White, Black, Hispanic, Asian and Others. The impact of race on GS was evaluated by Cox proportional hazard model. Risks were adjusted with recipients’ age, gender, BMI, diabetes mellitus, employment status, educational level, distance from transplant center to patients’ residence at transplant and donor’s age gender, BMI, race, donor type. Results: In total, 71,679 adult LT and 186,342 adult KT were performed from 2003-2013, of which 46,659LT/126,405KT recipients maintained graft function at 5 years post-transplantation. Kaplan-Meier analysis showed that Asian had the best and Black had the worst 10-year conditional GS in both KT and LT. (p<0.01) Black showed significantly lower 10-year conditional GS in KT, compared to White, after risk adjustment. (HR 1.07, 95%CI 1.03-1.11, p<0.01, Fig.1) In contrast, in LT, Black demonstrated comparable 10-year conditional GS to White after risk adjustment. (HR 1.07, 95%CI 0.95-1.20, p=0.259, Fig.2). In LT, the rate of cardiovascular disease (CVD) and malignancy as a cause of death was higher in White compared to Black. (28.5% vs 24.8%, 34.4% vs 23.8%, p<0.001) Conclusions: Black was associated with lower 10-year conditional GS in KT, whereas in LT, 10-year conditional GS between Black and White was comparable. Higher incidence of deaths due to CVD or malignancy in White LT patients might contribute to this finding. Further evaluations of factors contributing to disparities are necessary to address racial inequities in long-term post-transplant outcomes. [Formula presented] [Formula presented] CITATION INFORMATION: Rocha I., Oki R., Nishimagi A., Al-Juburi S., Rajendran L., Kerby E., Mohamed A., Nassar A., Al-Kurd A., Kim D., Yoshida A., Abouljoud M., Nagai S. Long-Term Conditional Graft Survival in Liver and Kidney Transplants: Does Race Matter Differently? AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: I. Rocha: None.
Volume
25
Issue
8
First Page
S277
