No Difference in Kidney Transplant Outcomes for Black vs. White Canadians

In contrast to disparities in the outcomes of kidney transplantation for African-American versus white patients in the United States, black and white kidney recipients in Canada have similar outcomes, according to a study in the Journal of the American Society of Nephrology.

Led by Karen Yeates, MD, of Queens University, Kingston, Ont., Canada, the researchers assessed the outcomes of 5036 renal transplant recipients in Canada, identified from a national registry. The transplants occurred in a group of 20,243 dialysis patients, of whom 3 percent were black and 97 percent white. Blacks were 41 percent less likely to undergo transplantation than white patients.

However, for transplant recipients, there was no racial difference in the risk of graft failure, after adjustment for comorbidity and socioeconomic status. Mortality after transplantation was 51 percent lower for blacks.

Why are the racial disparities observed in the United States not seen in Canada? Yeates speculates that black transplant recipients in Canada may have better access to post-transplant medical care, including immunosuppressive medications. While urging further study, the researchers write, “[O]ur results raise potentially important questions about whether better access to health services for African-Americans would improve outcomes following kidney transplantation in this population.” [Yeates K, Wiebe N, Gill J, Sima C, Schaubel D, Holland D, Hemmelgarn B, and Tonelli M: Similar outcomes among black and white renal allograft recipients. J Am Soc Nephrol 2009; 172–179].