Division of Nephrology, Department of Pediatrics, School of Medicine, Indiana University, 699 Riley Hospital Drive, Rm 230, Indianapolis, IN, 46202, USA.
Pediatr Nephrol. 2024 Sep;39(9):2593-2600. doi: 10.1007/s00467-024-06309-5. Epub 2024 Feb 12.
Racial disparities in pediatric kidney transplantation have been well described over the last two decades and include disparities in preemptive transplantation, waitlisting, time from activation to transplantation, living donation, and graft outcomes. Changes to the organ allocation system including the institution of Share 35 in 2005 and the Kidney Allocation System (KAS) of 2014 have resulted in resolution of some, but not all racial-ethnic disparities. Despite overall improvements in time from waitlist activation to transplant, disparities remain in preemptive transplantation, time to waitlisting, and living donor transplantation. Although improving under the KAS, racial disparities remain in graft survival as well. Racial disparity in kidney transplant access and graft survival is an international problem within pediatric nephrology. Although the racial group affected may differ, various minoritized pediatric groups across the world are affected by transplant disparities. Social determinants of health including financial access, language barriers, and the presence of a healthy living donor play a role in mediating these disparities. Further investigation is needed to better understand and intervene upon modifiable social, biological, and cultural factors driving the remaining disparity in transplant outcomes.
在过去的二十年中，儿科肾移植中的种族差异得到了充分的描述，包括抢先移植、等待名单、从激活到移植的时间、活体捐赠和移植物结果方面的差异。器官分配系统的变化，包括 2005 年实施的 Share 35 和 2014 年的肾脏分配系统 (KAS)，已经解决了一些种族差异问题，但并非所有种族差异问题都得到了解决。尽管从等待名单激活到移植的时间总体上有所改善，但抢先移植、等待名单时间和活体供体移植方面仍存在差异。尽管在 KAS 下有所改善，但移植物存活率仍存在种族差异。儿科肾脏病学中，肾脏移植机会和移植物存活率的种族差异是一个国际问题。尽管受影响的种族群体可能不同，但世界各地的各种少数族裔儿科群体都受到移植差异的影响。健康的社会决定因素，包括经济获取、语言障碍和健康活体供体的存在，在调解这些差异方面发挥着作用。需要进一步调查，以更好地了解和干预导致移植结果中仍存在差异的可改变的社会、生物和文化因素。
