Impact of Race on Renal Transplant Outcome

Dawidson, Ingemar; Coorpender, L.; Fisher, Daniel F.; Helderman, Harold; Hull, Alan R.; Palmer, Biff F.; Peters, Paul C.; Sagalowsky, Arthur I.; Sandor, Z.; Toto, Robert D.; Reisch, Joan

doi:10.1097/00007890-199001000-00014

Cited by 25 publications

(8 citation statements)

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“…African–American primary CRTs have historically experienced a higher incidence of acute rejection and poorer rates of patient and graft survival compared with any other race [1,9–13]. The reasons for this discrepancy have been attributed to HLA mismatching, mismatched Lewis blood group and medical noncompliance related to socioeconomic status [2,14–17].…”

Section: Discussionmentioning

confidence: 99%

Long-term results of a prospective randomized trial comparing tacrolimus versus cyclosporine in African- American recipients of primary cadaver renal transplant

et al. 2005

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Summary The ideal immunosuppressive treatment for African–American kidney transplant recipients has not been established. We performed a long‐term prospective randomized trial comparing the results of tacrolimus (TAC) and cyclosporine (CSA) in the African–American population. Thirty‐five African–American primary cadaveric renal transplant (CRT) recipients were enrolled in the study. Group I (n = 14) received TAC and group II (n = 21) received CSA; mean follow up was 78 months. We found no difference in patient/graft survival rates between the groups. Twelve patients in the CSA group were converted to TAC, mostly because of hypercholesterolemia or as a rescue for an acute rejection episode. Significant lower creatinine and cholesterol levels were seen at 1 year post‐transplant, but this difference lost significance at 3 and 5 years, possibly because of conversion of most patients from CSA to TAC. In conclusion, African–American recipients of primary CRTs can achieve excellent long‐term results with TAC‐based immunosuppression.

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Section: Discussionmentioning

confidence: 99%

Long-term results of a prospective randomized trial comparing tacrolimus versus cyclosporine in African- American recipients of primary cadaver renal transplant

et al. 2005

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“…[1][2][3][4][5] Several studies since the early 1980s have documented that AARTRs experienced more episodes of acute rejection and poorer long-term outcomes than other ethnic groups. [6][7][8] The introduction of newer immunosuppressive agents has improved outcomes slightly for African Americans, but not as dramatically as seen with Caucasians.…”

Section: Introductionmentioning

confidence: 99%

African American and Caucasian Renal Transplant Recipients Have Equal Acute Rejection Rates under Sirolimus and Tacrolimus Combination Therapy

El-Sabrout

Delaney²,

Butt³

et al. 2002

Graft

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“…African-American renal transplant recipients experience substantially greater rates of acute rejection episodes and allograft failure than Caucasian recipients [3,6,8,9,20,26,36,37,38,431 due to numerous factors. First, African-Americans tend to receive cadaveric allografts bearing a greater number of mismatched donorrecipient HLA and/or Lewis blood group antigens due to the predominance of Caucasian organ donors and to the high degree of polymorphism of antigens among and distinctive for African-Americans [2,31,391.…”

Section: Introductionmentioning

confidence: 99%

Sirolimus improves the two-year outcome of renal allografts in African-American patients

Podder

Podbielski²,

Hussein³

et al. 2001

Transplant International

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The present study evaluated whether the addition of sirolimus to a cyclosporine (CyA)/prednisone (Pred) regimen mitigated the greater proclivity to acute rejection episodes and graft loss characteristic of African-American renal transplant recipients. Using Kaplan-Meier and log-rank tests, African-American renal transplant recipients treated with either CyA/Pred (n = 90) or sirolimus/CyA/Pred (n = 47) were compared with 120 Caucasian patients treated with sirolimus/CyA/Pred for 2-year rates of patient and graft survival as well as acute rejection episodes. Mean laboratory values were compared using analysis of variance and F-tests. Addition of sirolimus to the CyA/Pred regimen reduced the incidence of acute rejection episodes in African-Americans from 43.3% to 19.2% (P = 0.004), a value similar to Caucasian patients. The 97.9% 2-year graft survival rate among 47 African-American patients treated with sirolimus/CyA/Pred was significantly higher than the 85.6% rate shown among the 90 CyA/Pred-treated African-American transplant recipients (P = 0.0479) and similar to that in Caucasians. The 95.7% patient survival rate among the African-American sirolimus/CyA/Pred group was similar to the 97.8% rate in the African-American CyA/Pred cohort. Interestingly, there was no evident toxicity from the addition of sirolimus. The addition of sirolimus to a CyA-based regimen reduced acute rejection episodes and graft loss experienced by African-American renal transplant recipients.

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Impact of Race on Renal Transplant Outcome

Cited by 25 publications

References 0 publications

Long-term results of a prospective randomized trial comparing tacrolimus versus cyclosporine in African- American recipients of primary cadaver renal transplant

Long-term results of a prospective randomized trial comparing tacrolimus versus cyclosporine in African- American recipients of primary cadaver renal transplant

African American and Caucasian Renal Transplant Recipients Have Equal Acute Rejection Rates under Sirolimus and Tacrolimus Combination Therapy

Sirolimus improves the two-year outcome of renal allografts in African-American patients

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