Kidney Transplant in Black Recipients: Are African Europeans Different from African Americans?

Pallet, Nicolas; Thervet, Éric; Alberti, Corinne; Emal-Aglaé, Violaine; Bedrossian, J.; Martinez, Frank; Roy, C Le; Legendre, Christophe

doi:10.1111/j.1600-6143.2005.01057.x

Cited by 66 publications

(49 citation statements)

References 32 publications

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“…These data suggest that dialysis-related environmental stimuli, rather than inherent variability of the T cell response, may contribute to immunologic differences between ethnic groups. One recent analysis of black European kidney transplant recipients found no increased rate of rejection compared with a white cohort (17). The black European patients who were analyzed seemed to have greater resources than many black transplant candidates (18), and dialysis vintage was not different between ethnic groups in this study (E. Thervet, Hospital Necker, Paris, France; personal communication, April 10, 2006).…”

Section: Discussionmentioning

confidence: 83%

Hemodialysis Vintage, Black Ethnicity, and Pretransplantation Antidonor Cellular Immunity in Kidney Transplant Recipients

Augustine

Poggio

Clemente

et al. 2007

Journal of the American Society of Nephrology

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Section: Discussionmentioning

confidence: 83%

Hemodialysis Vintage, Black Ethnicity, and Pretransplantation Antidonor Cellular Immunity in Kidney Transplant Recipients

Augustine

Poggio

Clemente

et al. 2007

Journal of the American Society of Nephrology

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“…A recent study from France showed comparable renal transplant outcomes for both white patients and patients of African descent. 36 Although less comparable to Canada, Brazil has also been shown to have similar graft survival among black versus white patients in the recipients of living-donor kidneys. 37 There are a number of limitations to our study.…”

Section: Discussionmentioning

confidence: 99%

Similar Outcomes among Black and White Renal Allograft Recipients

Yeates¹,

Wiebe²,

Gill³

et al. 2009

Journal of the American Society of Nephrology

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Black renal transplant recipients experience shorter graft survival than white recipients, but no published data describe the graft outcomes among black Canadian recipients. Here, we analyzed data from the Canadian national renal replacement therapy registry, which included 20,243 incident dialysis patients (3% black, 97% white), 5036 of whom received a renal transplant during the study period. Black patients were significantly less likely to receive a renal transplant (deceased and living-donor combined) when compared with white patients (hazard ratio 0.59; 95% confidence interval 0.51 to 0.69; P Ͻ 0.0001). Among patients who underwent a renal transplant, there was no significant difference in the likelihood of graft failure between black and white patients, even after adjustment for comorbidities and socioeconomic status; black patients, however, had significantly lower posttransplantation mortality compared with white patients (hazard ratio 0.49; 95% confidence interval 0.28 to 0.88; P ϭ 0.02). In conclusion, graft outcomes between black and white Canadian renal transplant patients are similar. Because this differs from the experience reported from the United States, further direct comparisons between the two populations is warranted.

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“…In France, which also has universal health coverage, Black recipients do as well as Caucasians [7]. The authors postulated that if significant physiologic differences between Blacks and Whites existed, they should be evidence worldwide, not limited to a single country such as the USA.…”

Section: Introductionmentioning

confidence: 99%

Influence of Race on Kidney Transplantation in the Department of Defense Healthcare System

et al. 2008

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Background: We report the influence of race on transplant outcomes in the Department of Defense (DOD) system. Methods: Retrospective cohort analysis of all kidney transplants performed at WRAMC from 1996 to 2005. Kaplan-Meier analysis was used to assess for differences in graft survival, and Cox regression was used to calculate adjusted hazard ratios for graft loss. For our analyses, we used the cutoff of 6 years (year 2000) when we introduced thymoglobulin induction; maintenance immunosuppression consisted of mycophenolate mofetil and tacrolimus, and rapid steroid taper (completed withdrawal at 6 weeks) was used for all patients. Results: There were 220 transplants (91 Blacks, 107 Caucasians and 22 Asians). Because the curve for graft survival for Blacks over time violated the proportional hazards assumption (at 6 years post-transplant), analysis was segregated into two segments. Through 6 years of follow-up, graft survival was 77% for Blacks and 81% for non-Blacks (p = 0.74 by log rank). Through 9 potential years of follow-up, graft survival for Blacks was 56% and 78% for Whites (p = 0.005). In Cox regression analysis, Black race, compared with non-Black race, was not significantly associated with graft loss at 6 years, but was significantly associated with graft loss occurring after 6 years. Conclusions: In the DOD health system, no significant differences were seen in graft survival among recipients of different races at 6 years. Black recipients who received a kidney transplant before the year 2000 showed decreased graft survival compared to non-Blacks. This was consistent with change in immunosuppressive regimen in our institution with the introduction of thymoglobulin induction and maintenance therapy with tacrolimus, mycophenolate mofetil and withdrawal of prednisone at 6 weeks.

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Kidney Transplant in Black Recipients: Are African Europeans Different from African Americans?

Cited by 66 publications

References 32 publications

Hemodialysis Vintage, Black Ethnicity, and Pretransplantation Antidonor Cellular Immunity in Kidney Transplant Recipients

Hemodialysis Vintage, Black Ethnicity, and Pretransplantation Antidonor Cellular Immunity in Kidney Transplant Recipients

Similar Outcomes among Black and White Renal Allograft Recipients

Influence of Race on Kidney Transplantation in the Department of Defense Healthcare System

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