Racial Disparities in Renal Allograft Survival: A Public Health Issue?

摘要: Background Racial disparities in renal transplantation outcomes have been documented with inferior allograft survival among African Americans compared non-African Americans. These differences attributed to a variety of factors, including immunologic hyperresponsiveness, socioeconomic status, compliance, HLA matching, and access care. The purpose this study was examine both nonimmunologic risk factors for loss goal defining targeted strategies improve Study Design We retrospectively analyzed all primary deceased-donor adult transplants (n = 2,453) at our center between May 1987 December 2004. Analysis included the impact recipient donor characteristics, typing, immunosuppressive regimen on graft outcomes. Data were using standard Kaplan-Meier actuarial techniques explored nonparametric parametric methods. Multivariable analyses hazard-function domain done identify specific associated loss. Results 1-year recipients improved substantially throughout period, 3-year also improved. Risk factor are shown by type according time periods. (acute rejection) most prominent during early phase. During late-phase, persists (chronic rejection), but recurrent disease, quality, recipient's comorbidities an increasingly greater role. Conclusions Advances immunosuppression regimens contributed late (constant) phases eras, improvement longterm continues lag behind disparity over indicates that beyond risk, variables, such as dialysis pretransplantation, diabetes, medical care, can be key issues.