Racial disparity in kidney transplant survival relates to late rejection and is independent of steroid withdrawal
dc.contributor.author | Liu, Angela | |
dc.contributor.author | Woodside, Kenneth J. | |
dc.contributor.author | Augustine, Joshua J. | |
dc.contributor.author | Sarabu, Nagaraju | |
dc.date.accessioned | 2018-11-20T15:31:38Z | |
dc.date.available | 2019-11-01T15:10:32Z | en |
dc.date.issued | 2018-09 | |
dc.identifier.citation | Liu, Angela; Woodside, Kenneth J.; Augustine, Joshua J.; Sarabu, Nagaraju (2018). "Racial disparity in kidney transplant survival relates to late rejection and is independent of steroid withdrawal." Clinical Transplantation 32(9): n/a-n/a. | |
dc.identifier.issn | 0902-0063 | |
dc.identifier.issn | 1399-0012 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/146287 | |
dc.description.abstract | Black kidney transplant recipients have more acute rejection (AR) and inferior graft survival. We sought to determine whether early steroid withdrawal (ESW) had an impact on AR and death‐censored graft loss (DCGL) in blacks. From 2006 to 2012, AR and graft survival were analyzed in 483 kidney recipients (208 black and 275 non‐black). Rates of ESW were similar between blacks (65%) and non‐blacks (67%). AR was defined as early (≤3 months) or late (>3 months). The impact of black race, early AR, and late AR on death‐censored graft failure was analyzed using univariate and multivariate Cox models. Blacks had greater dialysis vintage, more deceased donor transplants, and less HLA matching, yet rates of early AR were comparable between blacks and non‐blacks. However, black race was a risk factor for late AR (HR: 3.48 (95% CI: 1.87‐6.47)) Blacks had a greater rate of DCGL, partially driven by late AR (HR with late AR: 5.6; 95% CI: 3.3‐9.3). ESW had no significant interaction with black race for risk of early AR, late AR, or DCGL. Independent of ESW, black kidney recipients had a higher rate of late AR after kidney transplantation. Late AR was highly predictive of DCGL and contributed to inferior graft survival in blacks. | |
dc.publisher | Wiley Periodicals, Inc. | |
dc.subject.other | kidney transplant | |
dc.subject.other | acute rejection | |
dc.subject.other | African American | |
dc.subject.other | early steroid withdrawal | |
dc.subject.other | graft survival | |
dc.title | Racial disparity in kidney transplant survival relates to late rejection and is independent of steroid withdrawal | |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Medicine (General) | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/146287/1/ctr13381_am.pdf | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/146287/2/ctr13381.pdf | |
dc.identifier.doi | 10.1111/ctr.13381 | |
dc.identifier.source | Clinical Transplantation | |
dc.identifier.citedreference | Eckhoff DE, Young CJ, Gaston RS, et al. Racial disparities in renal allograft survival: a public health issue? J Am Coll Surg. 2007; 204: 894 ‐ 902. | |
dc.identifier.citedreference | Tankersley MR, Gaston RS, Curtis JJ, et al. The living donor process in kidney transplantation: influence of race and comorbidity. Transplant Proc. 1997; 29: 3722 ‐ 3723. | |
dc.identifier.citedreference | Chavalitdhamrong D, Gill J, Takemoto S, et al. Patient and graft outcomes from deceased kidney donors age 70 years and older: an analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing database. Transplantation. 2008; 85: 1573 ‐ 1579. | |
dc.identifier.citedreference | Rebellato LM, Arnold AN, Bozik KM, Haisch CE. HLA matching and the United Network for Organ Sharing Allocation System: impact of HLA matching on African‐American recipients of cadaveric kidney transplants. Transplantation. 2002; 74: 1634 ‐ 1636. | |
dc.identifier.citedreference | Dörje C, Midtvedt K, Holdaas H, et al. Early versus late acute antibody‐mediated rejection in renal transplant recipients. Transplantation. 2013; 96: 79 ‐ 84. | |
dc.identifier.citedreference | Koo EH, Jang HR, Lee JE, et al. The impact of early and late acute rejection on graft survival in renal transplantation. Kidney Res Clin Pract. 2015; 34: 160 ‐ 164. | |
dc.identifier.citedreference | Matas AJ, Gillingham KJ, Payne WD, Najarian JS. The impact of an acute rejection episode on long‐term renal allograft survival (t1/2). Transplantation. 1994; 57: 857 ‐ 859. | |
dc.identifier.citedreference | Sijpkens YWJ, Doxiadis IIN, Mallat MJK, et al. Early versus late acute rejection episodes in renal transplantation. Transplantation. 2003; 75: 204 ‐ 208. | |
dc.identifier.citedreference | Keith D, Patrie JT. Short‐term kidney transplant outcomes among African American recipients do not predict long‐term outcomes: donor pair analysis. Clin Transplant. 2011; 25: 69 ‐ 76. | |
dc.identifier.citedreference | Woodle ES, First MR, Pirsch J, et al.. A prospective, randomized, double‐blind, placebo‐controlled multicenter trial comparing early (7 day) corticosteroid cessation versus long‐term, low‐dose corticosteroid therapy. Ann Surg. 2008; 248: 564 ‐ 577. | |
dc.identifier.citedreference | Taber DJ, Hunt KJ, Gebregziabher M, et al. A comparative effectiveness analysis of early steroid withdrawal in black kidney transplant recipients. Clin J Am Soc Nephrol. 2017; 12: 131 ‐ 139. | |
dc.identifier.citedreference | Joseph JT, Kingsmore DB, Junor BJR, et al. The impact of late acute rejection after cadaveric kidney transplantation. Clin Transplant. 2001; 15: 221 ‐ 227. | |
dc.identifier.citedreference | Haas M, Sis B, Racusen LC, et al. Banff 2013 meeting report: inclusion of c4d‐negative antibody‐mediated rejection and antibody‐associated arterial lesions. Am J Transplant. 2014; 14: 272 ‐ 283. | |
dc.identifier.citedreference | Tanriover B, Jaikaransingh V, MacConmara MP, et al. Acute rejection rates and graft outcomes according to induction regimen among recipients of kidneys from deceased donors treated with tacrolimus and mycophenolate. Clin J Am Soc Nephrol. 2016; 11: 1650 ‐ 1661. | |
dc.identifier.citedreference | Butkus DE, Meydrech EF, Raju SS. Racial differences in the survival of cadaveric renal allografts. Overriding effects of HLA matching and socioeconomic factors. N Engl J Med. 1992; 327: 840 ‐ 845. | |
dc.identifier.citedreference | Narayanan M, Pankewycz O, Shihab F, Wiland A, McCague K, Chan L. Long‐term outcomes in African American kidney transplant recipients under contemporary immunosuppression: a four‐yr analysis of the Mycophenolic acid Observational REnal transplant (MORE) study. Clin Transplant. 2014; 28: 184 ‐ 191. | |
dc.identifier.citedreference | Gaber AO, Moore LW, Alloway RR, et al. Acute rejection characteristics from a prospective, randomized, double‐blind, placebo‐controlled multicenter trial of early corticosteroid withdrawal. Transplantation. 2013; 95: 573 ‐ 579. | |
dc.identifier.citedreference | Walsh RC, Brailey P, Girnita A, et al. Early and late acute antibody‐mediated rejection differ immunologically and in response to proteasome inhibition. Transplantation. 2011; 91: 1218 ‐ 1226. | |
dc.identifier.citedreference | Evans RW, Applegate WH, Briscoe DM, et al. Cost‐related immunosuppressive medication nonadherence among kidney transplant recipients. Clin J Am Soc Nephrol. 2010; 5: 2323 ‐ 2328. | |
dc.identifier.citedreference | Rodrigo E, Segundo DS, Fernández‐Fresnedo G, et al. Within‐patient variability in tacrolimus blood levels predicts kidney graft loss and donor‐specific antibody development. Transplantation. 2016; 100: 2479 ‐ 2485. | |
dc.identifier.citedreference | Taber DJ, Su Z, Fleming JN, et al. Tacrolimus trough concentration variability and disparities in African American kidney transplantation. Transplantation. 2017; 101: 2931 ‐ 2938. | |
dc.identifier.citedreference | Butler JA, Roderick P, Mullee M, Mason JC, Peveler RC. Frequency and impact of nonadherence to immunosuppressants after renal transplantation: a systematic review. Transplantation. 2004; 77: 769 ‐ 776. | |
dc.identifier.citedreference | Fine RN, Becker Y, De Geest S, et al. Nonadherence consensus conference summary report. Am J Transplant. 2009; 9: 35 ‐ 41. | |
dc.identifier.citedreference | Taber DJ, Egede LE, Baliga PK. Outcome disparities between African Americans and Caucasians in contemporary kidney transplant recipients. Am J Surg. 2017; 213: 666 ‐ 672. | |
dc.identifier.citedreference | Gralla J, Le CN, Cooper JE, Wiseman AC. The risk of acute rejection and the influence of induction agents in lower‐risk African American kidney transplant recipients receiving modern immunosuppression. Clin Transplant. 2014; 28: 292 ‐ 298. | |
dc.identifier.citedreference | Gordon EJ, Ladner DP, Caicedo JC, Franklin J. Disparities in kidney transplant outcomes: a review. Semin Nephrol. 2010; 30: 81 ‐ 89. | |
dc.identifier.citedreference | Joshi S, Gaynor JJ, Ciancio G. Review of ethnic disparities in access to renal transplantation. Clin Transplant 2012; 26: E337 ‐ E343. | |
dc.identifier.citedreference | Johansen KL, Zhang R, Huang Y, Patzer RE, Kutner NG. Association of race and insurance type with delayed assessment for kidney transplantation among patients initiating dialysis in the United States. Clin J Am Soc Nephrol. 2012; 7: 1490 ‐ 1497. | |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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