Racial disparities linked to likelihood, complications of living kidney donation

Black kidney transplant candidates had a decreased likelihood of living donor donation and black living donors experienced increased severity and frequency of perioperative complications following donation, according to data from two studies presented at ASN Kidney Week.

Douglas S. Keith, MD, medical director of the kidney transplant program at the University of Virginia School of Medicine, and colleagues investigated the impact of socioeconomic status on living donation rates.

The researchers identified kidney donation candidates in the Scientific Registry of Transplant Recipients database between 2000 and 2010 and linked that data with U.S. census data on median income by zip code.

Results demonstrated that higher rates of living donation were associated with increasing median income of a candidate's zip code across all ethnic and racial groups. Keith and colleagues reported that living donation rates were highest among whites, followed by Hispanics and Asians; blacks had the lowest overall living donation rates.

"Neighborhood poverty is associated with decreased likelihood of [living donation]," Keith and colleagues concluded. "This impact was most pronounced among [blacks]. Efforts should be made to remove financial disincentives to living donation to address racial and socioeconomic disparities in access to the life-saving treatment of transplant."

Krista L. Lentine , MD, PhD, a clinical scientist at Saint Louis University, and colleagues assessed the severity and frequency of perioperative complications after live kidney donation.

The researchers identified complications by linking administrative records from an academic hospital consortium and national U.S. donor registry data for 14,964 donors. They graded complication severity using Clavien scoring.

Lentine and colleagues found that 72.6% of donors were white and 11.6% were black. Black donors experienced higher rates of complications compared with white donors (18.2% vs. 15.5%; P = .005) as well as higher rates of complications at least a 4 on the Clavien severity scale (3.7% vs. 2.2%; P = .0002).

"[Black] race is independently associated with increased frequency and severity of perioperative complications after live donor nephrectomy," Lentine and colleagues concluded. "Future work should seek to identify underlying mechanisms and approaches to reducing outcome disparities." – by Chelsea Frajerman Pardes

References:

Keith DS, et al. Association of Neighborhood Poverty and Living Donor Kidney Transplant. Abstract FR-PO1002. Presented at: ASN Kidney Week 2015; Nov. 3-8; San Diego.

Lentine KL, et al. Racial Disparities in Perioperative Complications After Live Kidney Donation. Abstract FR-OR071. Presented at: ASN Kidney Week 2015; Nov. 3-8; San Diego.

Disclosures: Lentine is a consultant for and has an ownership interest in XynManagement, INC. Please see abstracts for a list of all other authors’ relevant financial disclosures.