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African-American Canadians who receive kidney transplants fare better than those in US
October 30, 2008Study raises questions about cause of disparities in the United States
African American kidney disease patients in both Canada and the United States are less likely than Caucasian Americans to have access to kidney transplants, but only African-Americans in the United States have worse health outcomes than Caucasians after a transplant is performed, according to a study appearing in the January 2009 issue of the Journal of the American Society Nephrology (JASN). The results could further open the debate about what has driven the disparities seen only in the United States.
Health disparities among different racial and ethnic groups have been noted for a number of conditions, including kidney disease. African-Americans in the United States in need of a kidney transplant are less likely to receive one than Caucasians, and even after they do receive a transplant, African-Americans in the United States experience higher rates of donor kidney failure and death. However, no studies have looked at disparities in health outcomes following kidney transplantation in Canada. A comparison of the two countries may shed light on the underlying causes of racial disparities among kidney transplant recipients.
Karen Yeates, MD, of Queens University in Kingston, Ontario, and her colleagues performed such a study by analyzing data from the Canadian national renal replacement therapy registry, which included information on 20,243 dialysis patients (3% black and 97% white), 5,036 of whom received a kidney transplant during the study.
The investigators found that African-Americans in Canada were significantly less likely than Caucasians to receive a kidney transplant, either from deceased or living donors. This situation mimics that seen in the United States. However, unlike African-Americans in the United States, African-American Canadians who underwent a kidney transplant experienced no significant health differences compared with Caucasians after their procedure. Their transplanted kidneys survived just as long as kidneys transplanted into Caucasians, and African-American Canadians actually survived longer following the surgery compared with Caucasians.
According to Dr. Yeates, the study's findings raise questions concerning why there are health disparity differences between the two countries. "Hypotheses behind this difference could be that the better renal transplant outcomes for African-Americans in Canada are due to better access to post-transplant medical care and access to immunosuppressive medications that are more comprehensive than in the United States," she said. (Unlike African-Americans in the United States, African-American Canadians have free access to pre-dialysis care, kidney transplantation and follow-up care at all kidney transplant centers.) Understanding these differences could highlight US policy issues related to access to medications and medical services that need to be improved.
"- [A]lthough this study is observation and further study is needed, our results raise potentially important questions about whether better access to health services for African-Americans would improve outcomes following kidney transplantation in this population," the authors wrote.
American Society of Nephrology
Karen Yeates, MD, of Queens University in Kingston, Ontario, and her colleagues performed such a study by analyzing data from the Canadian national renal replacement therapy registry, which included information on 20,243 dialysis patients (3% black and 97% white), 5,036 of whom received a kidney transplant during the study.
The investigators found that African-Americans in Canada were significantly less likely than Caucasians to receive a kidney transplant, either from deceased or living donors. This situation mimics that seen in the United States. However, unlike African-Americans in the United States, African-American Canadians who underwent a kidney transplant experienced no significant health differences compared with Caucasians after their procedure. Their transplanted kidneys survived just as long as kidneys transplanted into Caucasians, and African-American Canadians actually survived longer following the surgery compared with Caucasians.
According to Dr. Yeates, the study's findings raise questions concerning why there are health disparity differences between the two countries. "Hypotheses behind this difference could be that the better renal transplant outcomes for African-Americans in Canada are due to better access to post-transplant medical care and access to immunosuppressive medications that are more comprehensive than in the United States," she said. (Unlike African-Americans in the United States, African-American Canadians have free access to pre-dialysis care, kidney transplantation and follow-up care at all kidney transplant centers.) Understanding these differences could highlight US policy issues related to access to medications and medical services that need to be improved.
"- [A]lthough this study is observation and further study is needed, our results raise potentially important questions about whether better access to health services for African-Americans would improve outcomes following kidney transplantation in this population," the authors wrote.
American Society of Nephrology
Kidney Transplant Current Events and Kidney Transplant News RSSSwitching immunosuppressants reduces cancer risk in kidney
Switching to a newer type of immunosuppressant drug may reduce the high rate of skin cancer after kidney transplantation, according to research being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA.
Kidney transplants generally safe for lupus patients
Individuals with a history of lupus who receive a kidney transplant rarely develop the serious inflammatory condition lupus nephritis in their new organ, according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA.
Kidneys from deceased donors with acute renal failure expand donor pool
Kidneys recovered from deceased donors with acute renal failure (ARF) - once deemed unusable for transplant - appear to work just as well as kidneys transplanted from deceased donors who do not develop kidney problems prior to organ donation.
Link between depression, early stages of chronic kidney disease found by researchers
One in five patients with chronic kidney disease is depressed, even before beginning long-term dialysis therapy or developing end-stage renal disease, UT Southwestern Medical Center researchers have found.
New Discovery Brings Hope to Treatment of Lymphatic Diseases
Researchers in the laboratory of Dr. Jayakrishna Ambati at the University of Kentucky have discovered the first naturally occurring molecule that selectively blocks lymphatic vessel growth.
Mars and Venus: Short- and long-term success of male to female kidney transplants
Female recipients of kidneys from deceased male donors demonstrate an increased risk of allograft failure in the first year after transplant, but show no increased risk after ten years.
Post-transplant combo can replace toxic immune-suppressing drugs in monkeys
Transplant patients rely on drugs to prevent graft rejection, but at the cost of serious side effects.
Johns Hopkins leads first 16-patient, multicenter 'domino donor' kidney transplant
Surgical teams at The Johns Hopkins Hospital, Barnes-Jewish Hospital in St. Louis, INTEGRIS Baptist Medical Center in Oklahoma City and Henry Ford Hospital in Detroit successfully completed the first eight-way, multihospital, domino kidney transplant.
Microscopic 'beads' could help create 'designer' immune cells that ignore transplanted organs
The future of organ transplantation could include microscopic beads that create "designer" immune cells to help patients tolerate their new organ, Medical College of Georgia researchers say.
Older kidney transplant patients should more often consider live donors
Almost half of kidney transplant candidates older than 60 who are put on the waiting list for a deceased-donor organ will die before getting a transplant.
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