Transplant center assessment of the inequity in the kidney transplant process and outcomes for the Indigenous American patients

BackgroundThe goal is to determine the delays and reduced rates of kidney transplant (KTx) for the Indigenous Americans and variables predictive of these outcomes at a large single transplant center.Methods300 Indigenous Americans and 300 non-Hispanic white American patients presenting for KTx evaluation from 2012–2016 were studied.ResultsCompared to whites, the Indigenous Americans had the following: more diabetes, dialysis, physical limitation and worse socioeconomic characteristics(pConclusionsAmong patients referred and evaluated for KTx, the Indigenous American race was independently associated with significant delays in the KTx process after accounting for co-morbid and socioeconomic factors. Cardiovascular morbidity and physical limitation were identified as important determinants of delay and decreased likelihood of waitlisting. Further quantitative and qualitative work is needed to identify and intervene on modifiable barriers to improve access to KTx for the Indigenous Americans.