BLACKS AS DONORS FOR TRANSPLANTATION: SUBOPTIMAL OUTCOMES OVERCOME BY TRANSPLANTATION INTO OTHER MINORITIES

Abstract

O466 Aims: Since Opelz’s 1977 report, it has been known that kidneys from Blacks and Black recipients - fared statistically significantly (SS) poorer than all other ethnic groups. Methods: We compared the consequences of donation for all ethnic donors for kidney (KI), liver (LI), and heart (HR) transplantation and graft/patient survival of varied donor to recipient ethnic combinations. A total of 118,769 transplants were analyzed from the OPTN/UNOS database for the period of 4/01/94 - 12/31/2000 - 77,689 living and cadaveric kidney, 26,124 cadaveric liver, and 14,956 cadaveric heart transplants. A multi-variate Cox Regression Model analyzed the effect of donor recipient ethnicity combinations on graft survival in kidney and liver recipients, and patient survival in heart recipients. White, Black, Hispanic, Asian, and other minority groups were examined. Analysis included all donor recipient and transplant characteristics provided on the standard transplant UNOS forms. Results: The results are presented as relative risks (RR) of graft loss/mortality. For comparison purposes, the White to White combination was used as the baseline and given a score of 1.0. The results: 1) SS poorer outcomes are overcome when Black organs are transplanted into Hispanic, Asian or other minorities. 2) The highest RR was associated with Black heart donors (1.513), but was overcome when these hearts (Black) were transplanted into Asian and other minorities with a RR of 0.650.Figure* Asian and other minorities were combined due to small number Conclusions: 1. Poorer outcomes of Black donated organs are overcome when Black organs are transplanted into Hispanics, Asians or other minorities. 2. These differences mandate the need for research to help understand these differences.