J. Ortiz1, A. Parsikia2, S. Pinto3, P. Chang4, K. Khanmoradi2, S. Campos2, R. Zaki2 1Toledo University Medical Center,Toledo, OH, USA 2Einstein Healthcare Network,Philadelphia, PA, USA 3University Of Illinois Chicago (Metropolitan Group Hospital),Chicago, IL, USA 4Drexel University,Philadelphia, PA, USA
Introduction:
Geographic variations in kidney transplant outcomes are well documented but poorly understood.
Methods:
A retrospective analysis of recipients maintained in a standard database from NJ, NY and PA transplanted at a single center over the last eleven years was conducted.
Results:
PA recipients received a higher proportion of high-risk and HCV-positive donors and were more likely to be African-American, HCV positive and have had prior transplants. PA recipients recorded highest rates of delayed graft function in the immediate post-operative period and highest patient mortality and re-transplantation rates on long-term follow-up. Medium term outcomes (Overall patient survival rates at 1 and 3 years) were not significantly different between NJ (93.81%; 77.14%), NY (92.31%; 78.16%) and PA (88.64%; 70.17%) recipients (p>0.05).
Conclusions:
Higher waitlist times among NY and NJ recipients resulted in earlier transplantation when re-listed in Northern Philadelphia. Despite higher risk clinical profiles among PA patients,1- and 3- year patient and graft survival rates were not significantly different between the three patient categories. This may be indicative of closer follow-up of PA recipients. Nevertheless, long-term outcomes were significantly worse in PA patients. There was a not insignificant number of patients outside PA who were lost to follow-up.