Racial and Ethnic Disparities in Graft and Recipient Survival in Elderly Kidney Transplant Recipients.
Racial and Ethnic Disparities in Graft and Recipient Survival in Elderly Kidney Transplant Recipients.
复制标题
老年肾脏移植受者的移植物和受体存活率的种族和种族差异。
DOI：
10.1111/jgs.13845
复制
发表时间：
2015-12
影响因子：
6.3
通讯作者：
Patzer RE
中科院分区：
文献类型：
--
作者：
Ilori TO;Adedinsewo DA;Odewole O;Enofe N;Ojo AO;McClellan W;Patzer RE
在过去的十年中，老年肾移植受者人数的增加使得了解影响这一人群移植后结果的因素变得越来越重要。我们的目的是调查老年肾移植受者在移植物和患者存活率方面的种族/民族差异。回顾队列。所有首次、仅接受肾脏移植的人在联合器官共享网络(UNOS)数据库中的移植时年龄为60岁，在1996年7月至2010年10月期间移植，N=44,013。从联合国操作系统数据库中获得的移植失败和死亡的时间，并与社会保障死亡指数建立联系。根据2000年美国人口普查地理数据得出的社区贫困数据。在样本中的44,013名接受者中，20%是非洲裔美国人，63%是非西班牙裔白人，11%是西班牙裔，5%是亚洲人，其余的是“其他种族”。在调整后的COX模型中，我们发现与白人相比，非洲裔美国人更有可能发生移植失败(HR：1.23，95%CI：1.15，1.32)，而西班牙裔(HR：0.77，95%CI：0.70，0.85)和亚裔(HR：0.70，95%CI：0.61，0.81)发生移植失败的可能性较小。其次，与白人相比，非裔美国人(HR：0.84，95%CI：0.80，0.88)、西班牙裔(HR：0.68，95%CI：0.64，0.72)和亚洲人(HR：0.62，95%CI：0.57，0.68)在肾移植后死亡的可能性都较低。与白人移植接受者相比，老年非裔美国人移植失败的风险更高，但移植后存活时间更长。亚洲人的患者和移植物存活率最高，其次是西班牙裔。还需要进一步的研究来评估影响移植物和患者存活的其他因素，包括生活质量等结果。
The rise in the number of elderly kidney transplant recipients over the past decade makes it increasingly important to understand factors affecting post-transplant outcomes in this population. Our objective was to investigate the racial/ethnic differences in graft and patient survival among elderly kidney transplant recipients. Retrospective Cohort. All first-time, kidney-only transplant recipients ≥60 years of age at transplantation in the United Network for Organ Sharing (UNOS) database, transplanted between July 1996 and October 2010, N=44,013. Time to graft failure and death obtained from the UNOS database and linkage to the Social Security Death Index. Neighborhood poverty from 2000 U.S. Census geographic data. Of the 44,013 recipients in the sample, 20% were African American, 63% non-Hispanic white, 11% Hispanic, 5% Asian and the rest “other racial groups”. In adjusted Cox models, we found that compared to whites, African Americans were more likely to experience graft failure (HR: 1.23, 95%CI: 1.15, 1.32), while Hispanics, (HR: 0.77, 95%CI: 0.70, 0.85) and Asians (HR: 0.70, 95%CI: 0.61, 0.81) were less likely to experience graft failure. Secondly, compared to whites, African Americans (HR: 0.84, 95%CI: 0.80, 0.88), Hispanics (HR: 0.68, 95%CI: 0.64, 0.72), and Asians (HR: 0.62, 95%CI: 0.57, 0.68) all were less likely to die after renal transplantation. Elderly African Americans are at increased risk of graft failure compared to white transplant recipients, but survive longer after transplantation. Asians have the highest patient and graft survival followed by the Hispanics. Further studies are needed to assess additional factors affecting graft and patient survival including outcomes such as quality of life.