Geographic location may help explain why Hispanics face disparities in kidney transplantation

In the United States, Hispanics with kidney failure are less likely than non-Hispanic whites to receive a kidney transplant largely due to their blood type and because of where they live, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). The findings highlight the need to implement new deceased donor organ allocation policies that distribute organs over wider geographic areas to help reduce barriers to transplantation for Hispanics.

Hispanics represent the largest minority group in the United States and have an increased risk for developing compared with non-Hispanic whites. Prior studies have shown that Hispanics were less likely to be placed on the transplant waiting list, experienced longer waiting times, or were less likely to receive a kidney transplant compared with non-Hispanic whites. Cristina Maria Arce, MD (now at The Ohio State University Wexner Medical Center) and her former colleagues at Stanford University School of Medicine sought to study these issues further by analyzing data from the US Renal Data System, the national registry of individuals with kidney failure. The investigators identified 417,801 Caucasians who initiated dialysis from 1995 to 2007 and were followed through 2008.

Among the major findings:

  • Hispanics were just as likely as non-Hispanic whites to be put on the waitlist.
  • Once waitlisted, Hispanics were 21% less likely to receive a transplant from a deceased donor. But this disparity was largely explained by differences in patient blood type and regional variability of organ supply among organ procurement organizations across the country.

"The main barriers after placement on the waitlist include the tendency for Hispanics to reside in regions with organ procurement organizations characterized by longer median waiting times as well as the higher likelihood for Hispanics to have O, which further complicates organ allocations due to fewer ABO-compatible deceased donors," explained Dr. Arce. "To overcome the geographic disparities that Hispanics encounter in the path to transplantation, organ allocation policy revisions are needed to improve donor organ equity."

More information: The article, entitled "Differences in Access to Kidney Transplantation between Hispanic and non-Hispanic Whites by Geographic Location in the United States," will appear online on October 10, 2013, DOI: 10.2215/CJN01560213

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