Feyssa Eyob, Jones-Burton Charlotte, Ellison Gary, Philosophe Benjamin, Howell Charles
University of Maryland School of Medicine, Department of Medicine Baltimore, Maryland, USA.
J Natl Med Assoc. 2009 Feb;101(2):111-5. doi: 10.1016/s0027-9684(15)30822-1.
The purpose of this study was to evaluate the basis for the racial/ethnic disparity in kidney allograft survival.
We conducted a retrospective study of 2130 patients who underwent kidney transplantation between January 1995 and December 2003. Patient and graft survivals were compared using Kaplan-Meier analysis.
Black recipients were more likely than white recipients to have hepatitis C infection (24.6% vs 7.1%), current tobacco use (21.2% vs 13.1%), previous alcohol use (22.6% vs 9.7%), and past illicit drug use (13.6% vs 3.9%). Current employment was less common among blacks. Additionally, black recipients were more likely to have a prior kidney transplant (16.7% vs 11.0%) and to have a cadaver kidney donor (74% vs 56.5%). The 5-year allograft survival rate was 72% for whites and 59% for blacks (p < .01). Previous kidney transplantation, cadaveric donor, donor age, recipient employment status, and recipient tobacco use were associated with allograft survival in a Cox proportional hazard model.
Graft survival rate in black kidney transplant recipients is significantly lower than whites, and this disparity can be partially explained by the low rate of live donors and a higher previous transplantation rate in blacks.
本研究旨在评估肾移植受者生存率存在种族/民族差异的原因。
我们对1995年1月至2003年12月期间接受肾移植的2130例患者进行了一项回顾性研究。采用Kaplan-Meier分析比较患者和移植物的生存率。
黑人受者比白人受者更易感染丙型肝炎（24.6%对7.1%）、当前吸烟（21.2%对13.1%）、既往饮酒（22.6%对9.7%）和既往使用非法药物（13.6%对3.9%）。黑人当前就业情况较少见。此外，黑人受者更易有既往肾移植史（16.7%对11.0%）且接受尸体肾供者（74%对56.5%）。白人5年移植物生存率为72%，黑人为59%（p<0.01）。在Cox比例风险模型中，既往肾移植、尸体供者、供者年龄、受者就业状况和受者吸烟与移植物生存率相关。
黑人肾移植受者的移植物生存率显著低于白人，这种差异部分可归因于黑人活体供者比例低以及既往移植率较高。
