Kidney transplant outcomes of Māori and Pasifika people receiving transplantation in Australia: an Australia and New Zealand Dialysis and Transplant Registry study.

Abstract

Background: The numbers of Māori and Pasifika peoples with kidney failure living in Australia are rising. However, data describing outcomes of those proceeding to transplantation are limited. This study describes clinical outcomes of Māori and Pasifika peoples who received a kidney transplant in Australia.

Aims: This study describes clinical outcomes of Maori and Pasifika peoples who received a kidney transplant in Australia.

Methods: A retrospective review was conducted of kidney transplant recipients aged ≥18 years receiving their first graft between 1 January 2002 and 31 December 2021, as recorded in the Australia and New Zealand Dialysis and Transplant Registry. The primary outcome was death-censored graft survival. Secondary outcomes included delayed graft function (DGF), rejection and patient survival.

Results: Of 12 543 transplant recipients, mean age was 50 years and the majority identified as male sex. A total of 89 patients identified as Māori and 313 as Pasifika. Māori and Pasifika patients were more likely to have diabetic kidney disease or obesity at time of transplantation (body mass index > 30 kg/m²) and be current or former smokers compared to other ethnicities. Times to graft loss were shorter for Māori (adjusted hazard ratio (HR) 2.06, 95% confidence interval (CI) 1.36-3.11) and Pasifika (adjusted HR 1.78, 95% CI 1.39-2.029, P < 0.001) people compared to other ethnicities. The incidences of DGF were significantly higher in the Māori (30%) and Pasifika groups (28%) compared with 22% for other ethnicities (P < 0.005). Overall patient survival was comparable (Māori HR 0.93, 95% CI 0.57-1.49, P = 0.75; Pasifika HR 1.18, Cl 0.88-1.60, P = 0.26).

Conclusions: Times to graft loss for Māori and Pasifika kidney transplant patients were shorter than for other ethnicities.