By Kristina Rebelo
SAN DIEGO -- November 25, 2009 -- A study released during the American Society of Nephrology (ASN) Renal Week 2009, documents a possibility of lower patient survival in cases of non-black patients receiving black-donor kidneys.
The study showed that non-black donors to non-black recipients appeared to fare better in terms of survival.
For the study, researchers used the Kaplan-Meier and Cox regression analyses to look for risk factors for kidney transplantation patient mortality.
The group looked at recipients and donors in the United Network of Organ Sharing (UNOS) database between 1995 and 2008. UNOS reported 16,000 kidney transplants took place last year in the United States. The researchers identified and divided the groups into 4 categories based on donor and recipient race pairs of blacks and non-blacks.
"When comparing non-black donors to non-black recipients, there appeared to be an increased risk of patient mortality," Anita Patel, MD, Internal Medicine and Nephrology, Henry Ford Transplant Institute, Detroit, Michigan, told Doctor's Guide in an interview after the conference. "We were surprised at the results in that we thought there would not be a correlation between blacks and non-blacks. The comorbidity score and infections were a risk factor in all the groups."
After adjusting for all known variables, on regression analysis, the study found that the black donor/non-black recipient group had significantly lower survival rates (P = .01). Dr. Patel stressed that the data was retrospective and observational and that a prospective study needs to be accomplished with all transplant centres across the country contributing data.
Risk factors associated with lower patient survival included hepatitis C infection in both donor and recipient.
Dr. Patel recommended that before transplantation, patients with a high comorbidity score have their health issues stabilised to improve survival.
"An important aspect of this is looking at the comorbidity score and the need to get the patients stabilised before transplantation," explained Dr. Patel. "Diabetes is a major factor; the score includes the presence or absence of diabetes, hypertension, symptomatic peripheral vascular disease and symptomatic cardiovascular disease."
SOURCE: American Society of Nephrology Renal Week 2009
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