Association of Race and Ethnicity With Live Donor Kidney Transplantation in the United States From 1995 to 2014
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Importance Over the past 2 decades, there has been increased attention and effort to reduce disparities in live donor kidney transplantation (LDKT) for black, Hispanic, and Asian patients with end-stage kidney disease. The goal of this study was to investigate whether these efforts have been successful. Objective To estimate changes over time in racial/ethnic disparities in LDKT in the United States, accounting for differences in death and deceased donor kidney transplantation. Design, setting, and participants A secondary analysis of a prospectively maintained cohort study conducted in the United States of 453 162 adult first-time kidney transplantation candidates included in the Scientific Registry of Transplant Recipients between January 1, 1995, and December 31, 2014, with follow-up through December 31, 2016. Exposures Race/ethnicity. Main outcomes and measures The primary study outcome was time to LDKT. Multivariable Cox proportional hazards and competing risk models were constructed to assess changes in racial/ethnic disparities in LDKT among adults on the deceased donor kidney transplantation waiting list and interaction terms were used to test the statistical significance of temporal changes in racial/ethnic differences in receipt of LDKT. The adjusted subhazard ratios are estimates derived from the multivariable competing risk models. Data were categorized into 5-year increments (1995-1999, 2000-2004, 2005-2009, 2010-2014) to allow for an adequate sample size in each…
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Among adult first-time kidney transplantation candidates in the U.S. added to the deceased donor kidney transplantation waiting list between 1995 and 2014, disparities in the receipt of live donor kidney transplantation (LDKT) increased from 1995-1999 to 2010-2014.
“among adult first-time kidney transplantation candidates in the United States who were added to the deceased donor kidney transplantation waiting list between 1995 and 2014, disparities in the receipt of live donor kidney transplantation (LDKT) increased from 1995–1999 to 2010–2014 [67].”
From Reducing Racial Inequities in Health: Using What We Already Know to Take Action (2019) · cites this paper as [67]
In 1995, the cumulative incidence of LDKT at 2 years after appearing on the waiting list was 7.0% among white patients, 3.4% among black patients, 6.8% among Hispanic patients, and 5.1% among Asian patients; in 2014, it was 11.4% among white patients, 2.9% among black patients, 5.9% among Hispanic patients, and 5.6% among Asian patients.
“In 1995, the cumulative incidence of LDKT at 2 years after appearing on the waiting list was 7.0% among white patients, 3.4% among black patients, 6.8% among Hispanic patients, and 5.1% among Asian patients.”
From Reducing Racial Inequities in Health: Using What We Already Know to Take Action (2019) · cites this paper as [67]
From 1995-1999 to 2010-2014, racial disparities in the receipt of LDKT increased (p < 0.001 for all statistical interaction terms in adjusted models comparing white patients versus black, Hispanic, and Asian patients).
“From 1995–1999 to 2010–2014, racial disparities in the receipt of LDKT increased (p < 0.001 for all statistical interaction terms in adjusted models comparing white patients versus black, Hispanic, and Asian patients).”
From Reducing Racial Inequities in Health: Using What We Already Know to Take Action (2019) · cites this paper as [67]
Cites
A Proportional Hazards Model for the Subdistribution of a Competing Risk
Fine, J. P., & Gray, R. J. (1999) · Journal of the American Statistical Association · doi:10.1080/01621459.1999.10474144 · Cited by 14,290 · cited 2× · see citing works
“The adjusted subhazard ratios were estimated using competing risk models according to themethods of Fine and Gray.(17) Estimated adjusted subhazard ratios greater than 1 suggest that the racial/ethnic group is more likely to receive live donor kidney transplantation compared with white candidates.”
InfluentialPrevalence of Childhood and Adult Obesity in the United States, 2011-2012
Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014) · JAMA · doi:10.1001/jama.2014.732 · Cited by 8,072 · see citing works
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Reducing Racial Inequities in Health: Using What We Already Know to Take Action
Williams, D. R., & Cooper, L. A. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16040606 · Cited by 415 · see citing works
Self-citation
- Authors
- Purnell, T. S., Luo, X., Cooper, L. A., Massie, A. B., Kucirka, L. M., Henderson, M. L., Gordon, E. J., Crews, D. C., Boulware, L. E., & Segev, D. L.
- Affiliations
- Johns Hopkins University (US)
- Northwestern University (US)
- Duke University (US)
- Corresponding author
- Segev, Dorry L.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2018-01-02
- Volume
- 319
- Issue
- 1
- Pages
- 49
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC5833543
- OpenAlex
- W2782209540
- Cited by
- 309
- References
- 2
- Citations by year
- 2026: 27 · 2025: 33 · 2024: 40 · 2023: 33 · 2022: 43 · 2021: 45 · 2020: 45 · 2019: 30 · 2018: 12
- FWCI
- 31.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (K01 HS024600)
- National Heart, Lung, and Blood Institute (K24HL083113)
- National Institute of Allergy and Infectious Diseases (R03AI126090)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK098759, F30DK095545, R01DK104876, K24DK101828, K01DK114388, K23DK097184, K01DK101677)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Keywords
- living donor kidney transplantation, racial and ethnic disparities, end-stage renal disease, Black patients, Hispanic patients, Asian patients, time to transplant, deceased donor kidney transplantation, Scientific Registry of Transplant Recipients, kidney transplantation candidates
- MeSH terms
- Adult, Asian, Black or African American, Female, Hispanic or Latino, Humans, Kidney Failure, Chronic, Male, Middle Aged, United States, Waiting Lists, Cohort Studies, Kidney Transplantation, Living Donors, White People, Kaplan-Meier Estimate, Healthcare Disparities
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