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48390 Racial and Ethnic Disparities in Pediatric Kidney Transplantation - Has KAS made a difference?
ABSTRACT IMPACT: Evaluate the impact that the Kidney Allocation System has had on racial and ethnic disparities in pediatric deceased donor kidney transplant recipients. OBJECTIVES/GOALS: Racial and ethnic minority pediatric transplant candidates have known disparities in access to kidney transplant...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827735/ http://dx.doi.org/10.1017/cts.2021.590 |
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author | Charnaya, Olga Yu, Sile Goldberg, Aviva Garonzik-Wang, Jacqueline Segev, Dorry Verghese, Priya S. |
author_facet | Charnaya, Olga Yu, Sile Goldberg, Aviva Garonzik-Wang, Jacqueline Segev, Dorry Verghese, Priya S. |
author_sort | Charnaya, Olga |
collection | PubMed |
description | ABSTRACT IMPACT: Evaluate the impact that the Kidney Allocation System has had on racial and ethnic disparities in pediatric deceased donor kidney transplant recipients. OBJECTIVES/GOALS: Racial and ethnic minority pediatric transplant candidates have known disparities in access to kidney transplantation. The Kidney Allocation System (KAS), implemented in 2014, was designed in part to alleviate some of these disparities thereby making transplant more equitable. We investigated the effect of KAS on reported disparities. METHODS/STUDY POPULATION: We utilized Scientific Registry of Transplant Recipients (SRTR) data to determine differences in new waitlist registrants, deceased donor (DDKT) and living donor kidney transplants (LDKT), HLA mismatch, and allograft survival among pediatric patients of different racial and ethnic backgrounds. RESULTS/ANTICIPATED RESULTS: Black pediatric patients represented 21.3% of new waitlist registrants pre-KAS and 18.9% post-KAS. Waitlist time increased for pediatric patients of all races post-KAS with the highest increase (131 days) in Asian patients (p < 0.01). The racial distribution of DDKT pre- and post-KAS was unchanged (White 38.4% vs 38.3%, Black 24.5% vs 22.5%, Hispanic 30.6% vs 31.1%, Asian 3.7% vs 4.4%, p = 0.12). The 3-yr graft failure rate is disproportionately worse in Black children compared to other races pre- and post-KAS (White 6.8% vs 5.3%, Black 14% vs 8.7%, Hispanic 8% vs 4.5%, Asian 6.6% vs 6.7%, Other 6.5% vs 2.9%) although there is a trend towards better graft survival in the post-KAS era. Graft survival worsened in Asian children in the post-KAS era (HR 2.34,95% CI 1.05 - 5.25, p=0.038). DISCUSSION/SIGNIFICANCE OF FINDINGS: Racial and ethnic disparities in pediatric ESRD patients have not been ameliorated by KAS. Children of color have longer waitlist time and are more likely to have graft failure. Alarmingly, allograft failure rate increased in Asian patients post-KAS, which merits further evaluation. |
format | Online Article Text |
id | pubmed-8827735 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-88277352022-02-28 48390 Racial and Ethnic Disparities in Pediatric Kidney Transplantation - Has KAS made a difference? Charnaya, Olga Yu, Sile Goldberg, Aviva Garonzik-Wang, Jacqueline Segev, Dorry Verghese, Priya S. J Clin Transl Sci Health Equity & Community Engagement ABSTRACT IMPACT: Evaluate the impact that the Kidney Allocation System has had on racial and ethnic disparities in pediatric deceased donor kidney transplant recipients. OBJECTIVES/GOALS: Racial and ethnic minority pediatric transplant candidates have known disparities in access to kidney transplantation. The Kidney Allocation System (KAS), implemented in 2014, was designed in part to alleviate some of these disparities thereby making transplant more equitable. We investigated the effect of KAS on reported disparities. METHODS/STUDY POPULATION: We utilized Scientific Registry of Transplant Recipients (SRTR) data to determine differences in new waitlist registrants, deceased donor (DDKT) and living donor kidney transplants (LDKT), HLA mismatch, and allograft survival among pediatric patients of different racial and ethnic backgrounds. RESULTS/ANTICIPATED RESULTS: Black pediatric patients represented 21.3% of new waitlist registrants pre-KAS and 18.9% post-KAS. Waitlist time increased for pediatric patients of all races post-KAS with the highest increase (131 days) in Asian patients (p < 0.01). The racial distribution of DDKT pre- and post-KAS was unchanged (White 38.4% vs 38.3%, Black 24.5% vs 22.5%, Hispanic 30.6% vs 31.1%, Asian 3.7% vs 4.4%, p = 0.12). The 3-yr graft failure rate is disproportionately worse in Black children compared to other races pre- and post-KAS (White 6.8% vs 5.3%, Black 14% vs 8.7%, Hispanic 8% vs 4.5%, Asian 6.6% vs 6.7%, Other 6.5% vs 2.9%) although there is a trend towards better graft survival in the post-KAS era. Graft survival worsened in Asian children in the post-KAS era (HR 2.34,95% CI 1.05 - 5.25, p=0.038). DISCUSSION/SIGNIFICANCE OF FINDINGS: Racial and ethnic disparities in pediatric ESRD patients have not been ameliorated by KAS. Children of color have longer waitlist time and are more likely to have graft failure. Alarmingly, allograft failure rate increased in Asian patients post-KAS, which merits further evaluation. Cambridge University Press 2021-03-30 /pmc/articles/PMC8827735/ http://dx.doi.org/10.1017/cts.2021.590 Text en © The Association for Clinical and Translational Science 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Health Equity & Community Engagement Charnaya, Olga Yu, Sile Goldberg, Aviva Garonzik-Wang, Jacqueline Segev, Dorry Verghese, Priya S. 48390 Racial and Ethnic Disparities in Pediatric Kidney Transplantation - Has KAS made a difference? |
title | 48390 Racial and Ethnic Disparities in Pediatric Kidney Transplantation - Has KAS made a difference? |
title_full | 48390 Racial and Ethnic Disparities in Pediatric Kidney Transplantation - Has KAS made a difference? |
title_fullStr | 48390 Racial and Ethnic Disparities in Pediatric Kidney Transplantation - Has KAS made a difference? |
title_full_unstemmed | 48390 Racial and Ethnic Disparities in Pediatric Kidney Transplantation - Has KAS made a difference? |
title_short | 48390 Racial and Ethnic Disparities in Pediatric Kidney Transplantation - Has KAS made a difference? |
title_sort | 48390 racial and ethnic disparities in pediatric kidney transplantation - has kas made a difference? |
topic | Health Equity & Community Engagement |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827735/ http://dx.doi.org/10.1017/cts.2021.590 |
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