We read with great interest the report by Loucaidou et al. (1) regarding outcomes in South Asian renal transplant recipients in the United Kingdom. We wish to supplement their analysis with a report of our own experience in this population in Toronto, Canada. As a large cosmopolitan area, Toronto and its suburbs have a population exceeding 4 million of whom >50% are foreign-born (2001 Census). South Asians (SA), defined as individuals of Indian subcontinent ancestry, are a large visible ethnic minority in this city. We describe select renal transplant evaluation and posttransplant demographics and outcomes in SA at a single large transplant center in Toronto. A retrospective cross-sectional review of records in our transplant clinic was performed for patients 1) referred for pretransplant evaluation, 2) waitlisted, and 3) transplanted, all between July 1, 2000 and June 30, 2003. Comparisons were made between SA and non-SA using unpaired Student’s t test or chi-square analysis as appropriate. Fifty-six of 332 (17%) patients who presented for pretransplant evaluation were SA (55% male, 18% with live donor, 60% on hemodialysis, 39% diabetic). By contrast, 27% non-SA had an identified live donor (P<0.05 for difference), and 19% were diabetic (P<0.05). As of the study end period, 457 patients were waitlisted, of whom 64 (14%) were SA. Their blood type distribution was: A 17%, B 36%, O 44%, and AB 3%. By contrast, non-SA had the following distribution: A 34%, B 21%, O 42%, and AB 3%. SA were more likely to be blood type B (P<0.05). In addition, 4% of SA were CMV IgG negative compared with 24% among non-SA (P<0.01). Two-hundred twenty-four transplants were performed during this period (54% live donor, 57% male), of which 16 (7%) were performed in SA (31% live donor, 63% male). Patient and graft survival were 100% and 94%, respectively, in both SA and non-SA on June 30, 2003. Compared with non-SA, SA referred for transplantation were less likely to have an identified live donor and more likely to be diabetic. Waitlisted SA are more likely to be blood type B and be CMV IgG positive. A decreased proportion of SA in the transplanted group compared with the referred and waitlisted groups likely reflects the enlarging SA presence in Toronto in recent years coupled with long waiting times for a cadaveric kidney. SA are more likely to receive a cadaveric kidney and demonstrate excellent short-term graft survival. Further focused study of SA, who constitute >1 billion people worldwide is warranted in transplantation research. Oversimplification of race classification systems by assimilating this large group into other categories (e.g., Asian) for registry analyses should be discouraged. G. V. Ramesh Prasad Jeffrey S. Zaltzman Renal Transplant Program, St. Michael’s Hospital, Division of Nephrology, University of Toronto, Toronto, Canada Michael Huang Renal Transplant Program, St. Michael’s Hospital, Toronto, Canada