TY - JOUR
T1 - Donor Race Does Not Predict Graft Failure After Liver Transplantation
AU - Asrani, Sumeet K.
AU - Lim, Young Suk
AU - Therneau, Terry M.
AU - Pedersen, Rachel A.
AU - Heimbach, Julie
AU - Kim, W. Ray
N1 - Funding Information:
Funding This study was supported by a grant from the National Institutes of Health ( R01DK-34238 ) and a National Institutes of Health digestive diseases training grant ( T32 DK07198 ).
PY - 2010/6
Y1 - 2010/6
N2 - Background & Aims: Donor race has been proposed to predict graft failure after liver transplantation. We evaluated the extent to which the center where the transplantation surgery was performed and other potential confounding factors might account for the observed association between donor race and graft failure. Methods: We analyzed data from the Organ Procurement and Transplantation Network (January 2003-December 2005) for adult patients undergoing primary liver transplantation in the United States. We examined the association between graft failure and the donor races of African American (AA), Caucasian, Asian/Pacific Islander (API), or those classified as other. Results: Of 10,874 livers that were donated for transplantation, 7631 came from Caucasians, 1579 from AAs, 243 from APIs, and 1421 from others. After 36 months of follow-up evaluation, 2687 grafts failed. Without any adjustments, AA donors (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.00-1.24), API donors (HR, 1.41; 95% CI, 1.12-1.77), and other donors (HR, 1.16; 95% CI, 1.04-1.29) were associated with graft failure. After stratification by center and adjustments for age, height, and hepatitis B core antibody status of donors as well as serum creatinine and hepatitis C status of recipients, donor race was no longer statistically significant for AA (HR, 1.06; 95% CI, 0.95-1.20) and API (HR, 1.15; 95% CI, 0.89-1.49) donors. However, livers donated from members of other race still had an increased risk of graft failure (HR, 1.19; 95% CI, 1.05-1.35), although the effect was not uniform across donor-recipient pairs. Conclusions: Donor race is not a uniform predictor of graft failure and should not be construed as an indicator of donor quality.
AB - Background & Aims: Donor race has been proposed to predict graft failure after liver transplantation. We evaluated the extent to which the center where the transplantation surgery was performed and other potential confounding factors might account for the observed association between donor race and graft failure. Methods: We analyzed data from the Organ Procurement and Transplantation Network (January 2003-December 2005) for adult patients undergoing primary liver transplantation in the United States. We examined the association between graft failure and the donor races of African American (AA), Caucasian, Asian/Pacific Islander (API), or those classified as other. Results: Of 10,874 livers that were donated for transplantation, 7631 came from Caucasians, 1579 from AAs, 243 from APIs, and 1421 from others. After 36 months of follow-up evaluation, 2687 grafts failed. Without any adjustments, AA donors (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.00-1.24), API donors (HR, 1.41; 95% CI, 1.12-1.77), and other donors (HR, 1.16; 95% CI, 1.04-1.29) were associated with graft failure. After stratification by center and adjustments for age, height, and hepatitis B core antibody status of donors as well as serum creatinine and hepatitis C status of recipients, donor race was no longer statistically significant for AA (HR, 1.06; 95% CI, 0.95-1.20) and API (HR, 1.15; 95% CI, 0.89-1.49) donors. However, livers donated from members of other race still had an increased risk of graft failure (HR, 1.19; 95% CI, 1.05-1.35), although the effect was not uniform across donor-recipient pairs. Conclusions: Donor race is not a uniform predictor of graft failure and should not be construed as an indicator of donor quality.
KW - African American
KW - Donor Factors
KW - Donor Risk Index
KW - Organ Allocation
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U2 - 10.1053/j.gastro.2010.02.008
DO - 10.1053/j.gastro.2010.02.008
M3 - Article
C2 - 20176028
AN - SCOPUS:77952743198
SN - 0016-5085
VL - 138
SP - 2341
EP - 2347
JO - Gastroenterology
JF - Gastroenterology
IS - 7
ER -