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<p>Survival of patients on maintenance dialysis is longer in Black patients and patients who are obese. We sought to examine the interaction between transplant outcomes and self-reported race in obese kidney transplant recipients. Deceased donors for whom both kidneys were transplanted into first-time kidney alone recipients from 1/1/2000–12/31/2022 were identified from the United Network for Organ Sharing. Analysis was restricted to kidney recipients with BMI ≥ 30&#xa0;kg/m2 who self-identified as White or Black. Mate-kidney regression models were used to evaluate delayed graft function (DGF), post-transplant mortality, uncensored graft failure, and death-censored graft failure. There were 15,458 recipients in 7,729 mate-kidney pairs, of which 30% were Black, 31% were White, and 39% were discordant for race. At study end, 5,292 patients had died, of whom 3,263 died with a functioning allograft. Death occurred in 30% of Black patients and 38% of White patients (<i>P</i> &lt; 0.001). Allograft failures occurred in 39%. Adjusted mortality was lower in Black recipients, compared to Whites (HR = 0.84, 95%CI = 0.79, 0.90, <i>P</i> &lt; 0.001). Death-censored graft failure was higher in Black recipients (HR = 1.20, 95%CI = 1.10, 1.30, <i>P</i> &lt; 0.001), as was DGF (OR = 1.35, 95%CI = 1.19, 1.60, <i>P</i> &lt; 0.001). In conclusion, we observed longer survival in obese Black kidney transplant recipients, compared to White recipients, despite increased risks for DGF and death-censored graft failure.</p>

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Impact of Race on Outcomes in Obese Kidney Transplant Recipients: A Mate Kidney Analysis

  • 期刊论文

  • 发表日期：

    2025年10月14日

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  • Rita L. McGill,
  • Tomoki Tsukahara,
  • Bhavna Chopra,
  • Reem Daloul,
  • Kalathil K. Sureshkumar

摘要

Survival of patients on maintenance dialysis is longer in Black patients and patients who are obese. We sought to examine the interaction between transplant outcomes and self-reported race in obese kidney transplant recipients. Deceased donors for whom both kidneys were transplanted into first-time kidney alone recipients from 1/1/2000–12/31/2022 were identified from the United Network for Organ Sharing. Analysis was restricted to kidney recipients with BMI ≥ 30 kg/m2 who self-identified as White or Black. Mate-kidney regression models were used to evaluate delayed graft function (DGF), post-transplant mortality, uncensored graft failure, and death-censored graft failure. There were 15,458 recipients in 7,729 mate-kidney pairs, of which 30% were Black, 31% were White, and 39% were discordant for race. At study end, 5,292 patients had died, of whom 3,263 died with a functioning allograft. Death occurred in 30% of Black patients and 38% of White patients (P < 0.001). Allograft failures occurred in 39%. Adjusted mortality was lower in Black recipients, compared to Whites (HR = 0.84, 95%CI = 0.79, 0.90, P < 0.001). Death-censored graft failure was higher in Black recipients (HR = 1.20, 95%CI = 1.10, 1.30, P < 0.001), as was DGF (OR = 1.35, 95%CI = 1.19, 1.60, P < 0.001). In conclusion, we observed longer survival in obese Black kidney transplant recipients, compared to White recipients, despite increased risks for DGF and death-censored graft failure.