Kidneys Donated After Cardiac Death Cut Racial Disparities

By Robert Preidt

Using kidneys from donors who died of cardiovascular causes may help reduce disparities for black patients awaiting a kidney transplant, says a study by researchers at the Johns Hopkins Medical Institutions.

Black patients with end-stage renal disease (ESRD) comprise more than a third of the more than 70,000 Americans currently on the kidney transplant waiting list but are 2.7 times less likely than white patients to receive a new kidney, according to background information in the study. In addition, black patients are more likely than white patients to suffer kidney failure after transplantation.

Currently, kidneys from donors who've suffered brain death are commonly used for transplantation, while kidneys from people who've suffered cardiac death are rarely used, even though the use of such organs could increase the supply available for transplantation.

In this study, the Hopkins researchers compared the outcomes of more than 100,000 adults who received a deceased donor kidney transplant between 1993 and 2006. Among black patients, those who received kidneys from black cardiac death donors had better long-term kidney and patient survival than those who received kidneys from non-black donors.

The study also found that, compared with standard-criteria kidneys from white donors after brain death, kidneys from black donors after cardiac death conferred a 70 percent reduction in the risk of kidney loss and a 59 percent reduction in risk of death among black recipients.

Racial disparities were reduced when kidneys were donated after cardiac death compared with kidneys donated after brain death, the researchers found.

"These findings suggest that kidneys obtained from black donors after cardiac death may afford the best long-term survival for black recipients," the study authors wrote. In addition, their findings suggest that increased use of kidneys donated after cardiac death may reduce the shortage of available kidneys and decrease disparities for black patients.

The study was published online and was expected to be in the October print issue of the American Journal of Nephrology.