Does donor race still make a difference in deceased-donor African-American renal allograft recipients?

Brown, Kristian L.; Doshi, Mona D.; Singh, Atul; Mehta, Kalyani; Morawski, Katherina; Cincotta, Elizabeth; West, Miguel S.; Gruber, Scott A.

doi:10.1016/j.amjsurg.2009.08.025

« Previous Next »The American Journal of Surgery
Volume 199, Issue 3 , Pages 305-309, March 2010

Does donor race still make a difference in deceased-donor African-American renal allograft recipients?

Kristian L. Brown, M.D.
- Section of Transplant Surgery, Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
Mona D. Doshi, M.D.
- Division of Nephrology, Department of Medicine, Wayne State University School of Medicine, Detroit, MI
Atul Singh, M.D.
- Division of Nephrology, Department of Medicine, Wayne State University School of Medicine, Detroit, MI
Kalyani Mehta, M.D.
- Division of Nephrology, Department of Medicine, Wayne State University School of Medicine, Detroit, MI
Katherina Morawski, R.N., B.S.N., C.N.N.
- Section of Transplant Surgery, Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
Elizabeth Cincotta, Pharm.D.
- Pharmacy Department, Harper University Hospital, Detroit, MI, USA
Miguel S. West, M.D., F.A.C.S.
- Section of Transplant Surgery, Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
Scott A. Gruber, M.D., Ph.D., M.B.A., F.A.C.S.
- Section of Transplant Surgery, Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
- Corresponding author. Tel.: + 1 313 745 7319; fax: + 1 313 993 0595

Received 27 July 2009

Abstract

Background

Prior studies have demonstrated that African-American (AA) donor kidneys are independently associated with an increased risk for graft loss.

Methods

We examined outcomes in comparable groups of AA deceased-donor (DD) kidney transplant patients receiving an AA donor (n = 35) versus a Caucasian donor (C group; n = 150) organ.

Results

There were no differences between AA and C groups in patient survival, new-onset diabetes, or BK nephropathy. The AA group demonstrated a significantly higher 6-month and overall incidence of acute rejection (AR), increased cytomegalovirus (CMV) infection, and decreased graft survival. Recurrent or de novo focal segmental glomerulosclerosis (FSGS) accounted for a significantly higher fraction of graft losses in the AA versus C group.

Conclusions

AA DD renal allograft recipients have equivalent patient but decreased graft survival when transplanted with an AA versus C kidney using current immunosuppression. This may be the result of increased AR, CMV infection, and recurrence/development of FSGS.

Keywords: Donor race, Kidney transplantation, African American