C. Pham1, J. Vu1, M. Gunder1, S. Karhadkar1 1Temple University,SURGERY / ABDOMINAL ORGAN TRANSPLANTATION,Philadelpha, PA, USA
Introduction:
The Kidney Allocation System (KAS) was implemented in 2014, in part due to high discard rates of kidneys and variability in access to transplants for candidates who are harder to match due to biologic reasons. Prior to implementation, there has been a clear reported racial disparity in recipients of renal transplantation. According to the Organ Procurement and Transplantation Network (OPTN), African Americans were receiving fewer transplants than their Caucasian counterparts. This study aims to analyze whether implementation of the new KAS has made an impact on the percent of African Americans receiving renal transplants as well as to determine if geographical disparities exist. Aditionally, we sought to analyze the 'bolus' effect on KAS.
Methods:
Data from OPTN annual data reports and Scientific Registry of Transplant Recipients (SRTR) Program Specific Reports was analyzed to determine rates of renal transplantation each year between 2012 and 2018. Data was categorized by recipient ethnicity and geographical location.Demographic characteristics of waiting list candidates was used to calculate the number of white, black, or other patients on the waiting list for the OPTN region the transplant center belongs to. This was done for each region in each year between 2012 and 2018. Percent of African Americans who received a renal transplant in each region for a selected year (z), given the number of African American patients who received a renal transplant in said year obtained from OPTN data reports (x), and number of African American patients on the waitlist during the same year obtained from SRTR Program Specific Reports (y) were calculated. Percent of Caucasians and Other who received a renal transplant in each region were calculatedin the same manner as mentioned above, but with their respective ethnicities.
Results:
We observed that differences in rates of transplantation are seen across the 11 OTPN regions, with Region 8 most notably and consistently having the highest rates of transplantation across all racial groups before and after KAS implementation. In addition, KAS corrected some racial disparities as the gap between African Americans and Caucasians receiving transplantations have narrowed. Correction of disparities was not transient and persisted after two years post KAS implementation.
Conclusion:
Racial disparities still exist in kidney transplantation. African American patients are consistently being transplanted at a lesser rate than their Caucasian counterparts. Second, regional disparities exist. There is a wide range of transplantation rates regionally for every racial group. KAS corrected some racial disparities. Finally, correction of disparities was not transient and persisted after two years.
