Disparities in Kidney Transplant Outcomes: A Review

Elisa J. Gordon*, Daniela P. Ladner, Juan Carlos Caicedo, John Franklin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

114 Scopus citations

Abstract

Sociocultural and socioeconomic disparities in graft survival, graft function, and patient survival in adult kidney transplant recipients are reviewed. Studies consistently document worse outcomes for black patients, patients with low income, and patients with less education, whereas better outcomes are reported in Hispanic and Asian kidney transplant recipients. However, the distinct roles of racial/ethnic versus socioeconomic factors remain unclear. Attention to potential pathways contributing to disparities has been limited to immunologic and nonimmunologic factors, for which the mechanisms have yet to be fully illuminated. Interventions to reduce disparities have focused on modifying immunosuppressant regimens. Modifying access to care and health care funding policies for immunosuppressive medication coverage also are discussed. The implementation of culturally sensitive approaches to the care of transplant candidates and recipients is promising. Future research is needed to examine the mechanisms contributing to disparities in graft survival and ultimately to intervene effectively.

Original languageEnglish (US)
Pages (from-to)81-89
Number of pages9
JournalSeminars in nephrology
Volume30
Issue number1
DOIs
StatePublished - Jan 2010

Funding

Supported by a Career Development Award from the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (DK063953 to E.J.G.).

Keywords

  • Kidney transplantation
  • disparities
  • graft survival
  • outcomes
  • patient survival
  • race/ethnicity
  • socioeconomic status

ASJC Scopus subject areas

  • Nephrology

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