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Kidney Transplant Outcomes in Indigenous People of the Northern Great Plains of the United States
- Source :
- Transplantation Proceedings. 53:1872-1879
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Indigenous people experience higher rates of end-stage renal disease as well as negative predictive factors that undermine kidney transplantation (KT) success. Despite these inequalities, data suggest that short-term outcomes are comparable to those of other groups, but few studies have examined this effect in the Northern Great Plains (NGP) region. Methods We performed a retrospective database review to determine outcomes of KT in Indigenous people of the NGP. White and Indigenous people receiving a KT between 2000 and 2018 at a single center were examined. Results A total of 622 KT recipients were included (117 Indigenous and 505 White). Indigenous patients were more likely to smoke, have diabetes, have higher immunologic risk, receive fewer living donor kidneys, and have longer waitlist times. In the 5 years after KT there were no significant differences in renal function, rejection events, cancer, graft failure, or patient survival. At 10 years posttransplant, Indigenous patients had twice the all-cause graft failure (odds ratio = 2.06; 95% confidence interval, 1.25–3.39) and half the survival rate (odds ratio = 0.47; 95% confidence interval, 0.29–0.76); however, this effect was not maintained once the effects of race, sex, smoking status, diabetes, preemptive transplant, high panel reactive antibody status, and transplant type were adjusted for. Conclusions KT outcomes in Indigenous patients in the NGP region are similar to those of White patients 5 years posttransplant, with differences emerging at 10 years that could be diminished with greater emphasis on correcting modifiable risk factors.
- Subjects :
- Graft Rejection
Transplantation
business.industry
Graft Survival
Panel reactive antibody
Disease
Single Center
medicine.disease
Kidney Transplantation
United States
Indigenous
Confidence interval
Treatment Outcome
Diabetes mellitus
Living Donors
medicine
Humans
Kidney Failure, Chronic
Surgery
Indigenous Peoples
business
Survival rate
Kidney transplantation
Retrospective Studies
Demography
Subjects
Details
- ISSN :
- 00411345
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- Transplantation Proceedings
- Accession number :
- edsair.doi.dedup.....73e4eabae21d9f29ddfc2f6f41b3b479
- Full Text :
- https://doi.org/10.1016/j.transproceed.2021.05.003