Among patients with simultaneous pancreas-kidney transplantation, Black recipients may be at greater risk for dual immunologic graft loss, and White patients may be at greater risk for death with a functioning graft (DWFG), investigators reported in a poster presentation at the virtual American Transplant Congress 2021.
Jeffrey Rogers, MD, of Wake Forest Baptist Medical Center in Winston-Salem, North Carolina and collaborators studied 158 White and 57 Black patients transplanted at their center from 2001 to 2019.
Black patients had significantly better survival (88% vs 74%). Kidney (67% vs 63%) and pancreas (61% vs 57%) graft survival rates also slightly favored Black recipients. Death-censored dual graft loss, however, was higher for Black patients (23% vs 11%).
Death with a functioning graft was more common in White (18%) than Black patients (8%). White patients had a higher rate of early graft loss compared with Black patients (7.6% vs 3.5%), but they had lower rates of cumulative clinical acute rejection (27% vs 33%).
Despite similar recipient and donor age and sex, Black patients in this cohort were significantly more likely to have a dialysis duration longer than 20 months (51% vs 24%) and less likely to be on peritoneal dialysis (10% vs 30%). Significantly more Black than White patients were sensitized with 20% or more panel reactive antibodies (19% vs 6%) and had 5 to 6 HLA mismatches (67% vs 49%).
Significantly more Black than White patients had type 2 diabetes for less than 20 years (47% vs 23%), developed it after age 24 (30% vs 13%), and had pretransplant C-peptide levels of 2.0 ng/mL or more (33% vs 13%).
Rogers J, Farney A, Orlando G, et al. Simultaneous pancreas-kidney transplantation in Caucasian versus African American patients: Does recipient ethnicity influence outcomes? Am J Transplant. 2021;21 (suppl 3). Presented at the virtual American Transplant Congress 2021, June 5-9, 2021. Abstract 421.