M. Janeway2, A. Foster1, S. De Gue2, K. Curreri2, T. Dechert2, M. Nuhn2 1Boston University School of Medicine,Boston, MA, USA 2Boston Medical Center,Department Of Surgery,Boston, MA, USA
Introduction: Health and financial benefits of renal transplant are well demonstrated, yet transplantation in undocumented immigrants remains rare and little published data on outcomes in this population exists. We investigated whether undocumented immigrants have similar outcomes after renal transplant compared to documented recipients.
Methods: We retrospectively analyzed records of adult renal transplant recipients at our academic medical center between 2002 and 2016. Primary endpoints were recipient and graft survival. Secondary endpoints were delayed graft function (DGF), acute rejection, and post-transplant complications. Patients were matched 1:1 using a propensity score matching model based on age, sex, race, type of donor (living vs. cadaveric), and cause of end-stage renal disease.
Results: We identified 44 undocumented and 137 documented patients. Undocumented patients were younger and more likely to receive a living-donor kidney. Unadjusted survival rates were comparable between undocumented and documented recipients at 1-year (97% vs. 96%) and 3-years (96% vs. 96%), as were graft survival at 1-year (92% vs. 93%) and at 3-years (87% vs. 86%), and post-transplant complications (44% vs. 41%). After matching, documentation status was not significantly associated with graft survival at one year (OR=1.50, 95%CI[0.27, 9.50], p= 0.6669) or three years (OR=1.33, 95%CI[0.30, 5.88] p=0.7039), DGF (OR=1.62, 95%CI[0.57, 4.59], p=0.3632), acute rejection (OR=1.58, 95%CI[0.25, 10.00], p=0.6265), transplant complications (OR 1.62, [0.68, 3.84], p=0.2752), or post-transplant CKD (OR=0.60, [0.20, 1.80] p=0.3598).
Conclusion: Documentation status is not associated with adverse renal transplant outcomes in this small study. Given these outcomes data, we feel transplant centers should consider renal transplant for undocumented patients.