While the percentage of kidney transplants involving live donors has remained stable for other minority populations, African Americans have seen a decline in live donors even as more of them receive kidney transplants, according to a study by Henry Ford Hospital in Detroit.
Those findings will be presented May 8 at the annual meeting of the American Urological Association in San Diego.
"African American race has been associated with disparities in care at every step of the kidney transplant process," says Jesse D. Sammon, D.O., a researcher at Henry Ford's Vattikuti Urology Institute and lead author of the study. "This is particularly striking in the use of transplant kidneys from living donors."
"Live-donor kidney transplant offers a patient the best chance for long term survival off dialysis and African Americans have been found to have barely half the odds of other racial groups of getting live-donor kidney transplant."
So the Henry Ford research team set out to look at trends for donor nephrectomy – or the removal of a kidney to donate for transplant – as a percentage of kidney transplants within minority populations.
Using data drawn from the Nationwide Inpatient Sample, which includes discharge statistics from more than 1,000 U.S. hospitals in 44 states, the Henry Ford research team found an estimated 205,984 kidney transplants (KT) were performed between 1998 and 2010.
At the same time, data showed 72,352 live-donor nephrectomies (LDN) for a comparative percent overall of 35.12, which remained consistent during the study period. Within the overall study population, the rate for Hispanics also was consistent and averaged 30.3 percent, and rates for other minority groups, too, remained stable and averaged 26.33 percent.
"But African Americans averaged only 18.6 percent LDN to KT ratio, and that fell over the study period," Dr. Sammon says.
Noting that abundant research has found much higher levels of certain serious diseases among African Americans, for a variety of reasons that remain at least partially unclear, Dr. Sammon says that may well explain the disparity in live-donor kidney transplants.
"It likely reflects a lower number of potential donors in the social networks of African Americans due to higher prevalence of obesity, hypertension and diabetes, as well as social/cultural impediments to live donation," Dr. Sammon says.