Division of Nephrology, Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, ON, Canada.
Division of Nephrology, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA.
Transpl Int. 2019 Oct;32(10):1030-1043. doi: 10.1111/tri.13476. Epub 2019 Jul 12.
Patients from ethnocultural minorities have reduced access to live donor kidney transplant (LDKT). To explore early pretransplant ethnocultural disparities in LDKT readiness, and the impact of the interactions with the transplant program, we assessed if patients had a potential live donor (LD) identified at first pretransplant assessment, and if patients with no LD initially received LDKT subsequently. Single-center, retrospective cohort of adults referred for kidney transplant (KT) assessment. Multivariable logistic regression assessed the association between ethnicity and having a potential LD. Cox proportional hazard analysis assessed the association between no potential LD initially and subsequent LDKT. Of 1617 participants, 66% of Caucasians indicated having a potential LD, compared with 55% of South Asians, 44% of African Canadians, and 41% of East Asians (P < 0.001). In multivariable logistic regression analysis, the odds of having a potential LD identified was significantly lower for African, East and South Asian Canadians. No potential LD at initial KT assessment was associated with lower likelihood of LDKT subsequently (hazard ratio [HR], 0.14; [0.10-0.19]). Compared to Caucasians, African, East and South Asian and African Canadians are less likely to have a potential LD identified at first KT assessment, which predicts a lower likelihood of subsequent LDKT.
少数民族患者接受活体供肾移植（LDKT）的机会较少。为了探讨 LDKT 准备阶段早期的种族文化差异，以及这种差异与移植项目之间的相互作用的影响，我们评估了患者在首次移植前评估时是否有潜在的活体供者（LD），以及最初没有 LD 的患者随后是否接受了 LDKT。这是一项单中心、回顾性的成年人接受肾移植（KT）评估的队列研究。多变量逻辑回归评估了种族与潜在 LD 之间的关联。Cox 比例风险分析评估了最初没有潜在 LD 与随后的 LDKT 之间的关联。在 1617 名参与者中，66%的白种人表示有潜在的 LD，而南亚人、非裔加拿大人、东亚人分别为 55%、44%和 41%（P<0.001）。多变量逻辑回归分析显示，非裔、东亚和南亚加拿大人有潜在 LD 的可能性显著降低。在初次 KT 评估时没有潜在 LD 与随后接受 LDKT 的可能性较低相关（风险比 [HR]，0.14；[0.10-0.19]）。与白种人相比，非裔、东亚和南亚以及非裔加拿大人在首次 KT 评估时更不可能确定有潜在 LD，这预示着随后接受 LDKT 的可能性较低。
