Effect of race on outcome following kidney and kidney–pancreas transplantation in type I diabetics: the South‐Eastern Organ Procurement Foundation experience*

In this study we analyze the South‐Eastern Organ Procurement Foundation (SEOPF) experience with kidney and kidney‐pancreas transplantation in IDDM recipients and evaluate the impact of racial disparity on patient and graft outcome. Data obtained from 4413 kidney‐alone and 884 pancreas transplants performed in White and Black type I diabetics at member institutions of SEOPF between 10/1/87 and 7/25/96 were analyzed. Survival data from 15,827 transplants performed during the same period of time in non‐diabetics were available for comparison. A lesser proportion of pancreas recipients were Black compared to kidney‐alone (12% vs 23%, p<0.0005). Recipient race had no effect on patient survival in any of the groups studied. Kidney graft survival, on the other hand, was adversely affected by Black race in both non‐diabetic and diabetic recipients of a kidney transplant but not in diabetics who received a combined pancreas‐kidney transplant. As was the case for patient survival in diabetics, recipient race had no effect on pancreas graft survival. Cox Regression analysis showed that kidney‐pancreas transplant (p=0.034, RR=0.49) and female recipient gender (p=0.046, RR=0.68) were associated with a lower risk of failure of the pancreas graft. The following factors were independent predictors of kidney graft outcome: Donor age (p=0.0001, RR=0.95), kidneypancreas transplant (p=0.0004, RR=0.58), AB match (p=0.001, RR=0.86), DR match (p=0.006, RR=0.82), preservation time (p=0.012, RR=1.01), Black recipient race (p=0.047, RR=1.23) and living donor (p=0.06, RR=0.73). Our findings suggest that the effect of race on graft outcome observed in non‐diabetic and, to a lesser extent, diabetic kidney‐alone transplant recipients, is not present after kidney‐pancreas transplantation.