African-American Kidneys May Worsen Transplant Outcomes

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Recipients of kidneys from African Americans (AA) are at increased risk of all-cause and cardiovascular mortality compared with patients who receive kidneys from non-AA donors, investigators reported. Non-AA recipients of AA kidneys also are at increased risk of death-censored graft failure.

In a study of 13,692 hemodialysis patients who underwent renal transplantation, recipients of an AA kidney had a 39%, 80%, and 30% increased risk of all-cause mortality, cardiovascular mortality, and death-censored graft loss, respectively, over a six-year observation period, after adjusting for relevant clinical and transplant-related variables. Recipients were not at increased risk for delayed graft function.

Among non-AA recipients—but not AA recipients—AA donor race was associated with a significant twofold higher risk of death-censored graft loss in a fully adjusted model, according to the investigators.

The study was led by Kamyar Kalantar-Zadeh, MD, MPH, PhD and findings were presented by Miklos Z. Molnar, MD, PhD. Both researchers are affiliated with the Harbor-UCLA Medical Center in Torrance, Calif.

Future studies should test specific interventions aimed at abnormalities that are characteristic of allografts harvested from AA donors to improve outcomes in recipients of these organs, the authors noted.

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