Hispanic Donor Kidneys Associated with Longer Survival
MIAMI BEACH, Fla. —Living kidney donations by Latinos result in significantly higher patient survival rates, according to a recent analysis of large transplantation databases.
An analysis of information from the Organ Procurement and Transplantation Network and the United Network for Organ Sharing showed a positive outcome is 47% more likely with organ donation from a Latino than with a donor of another ethnicity.
The study, which was presented in poster form at the American Society of Transplant Surgeon's 2012 Annual State of the Art Winter Symposium, also indicated that graft survival is shorter with donation of a kidney from a female to a male compared to other gender pairings.
“Donor's Hispanic ethnicity, female donor to male recipient and HLA match level were significant prognostic factors for graft and patient survival,” the investigators noted. “Donor's age was not found to be a significant factor in recipient outcomes.”
Sander Florman, MD, Director, Recanati-Miller Transplant Institute, Mount Sinai School of Medicine, New York City, and nine other researchers analyzed data from 72,732 people who underwent a nephrectomy and received a kidney from a living donor between October 1987 and March 2011. They focused on the subset of 56,475 who had a laparoscopic nephrectomy; these were mainly from 2000 onwards.
The overall rate of five-year patient survival was 92%. The investigators performed a univariate analysis that showed the following were significant prognostic factors for overall graft and patient survival: donor age over 60 years, donor with Hispanic ethnicity, high donor-to-recipient weight ratio, high donor-to-recipient body mass index ratio, donor glomerular filtration rate of less than 91 mL/min/1.73 m2, HLA match level and female donor to male recipient.
They then performed a multivariate analysis that showed that the only factor they examined that significantly predicts longer patient survival is Hispanic ethnicity of the donor. This was associated with a hazard ratio of 0.528, which translates into a 47.2% higher probability of survival. The only factors that significantly predict shorter graft survival are HLA match level and female donor to male recipient, with the latter being associated with a 32% lower probability of graft survival.