Indo-Asian experience of renal transplantation in Yorkshire

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Abstract
Background. There is a significant Indo-Asian community in Yorkshire. The rate of end-stage renal failure is disproportionately high in this ethnic group. There have not been any large studies of this ethnic minority’s access to and outcome after cadaveric renal transplantation. Methods. Three local cohorts were studied: 846 adult patients (9.1% Asian) who started renal replacement therapy 1990–1994, 822 adult patients (11.4% Asian) registered on the transplant waiting list 1985–1994; and 608 adult patients (8.6% Asian) transplanted 1985–1994. Results. At 1 year from the start of dialysis, 34% of Asian and 31% of non-Asian patients were registered onto the waiting list. After adjustment for age in a multifactorial model, Asian patients were less likely to be listed (relative risk, 0.68), although this did not reach statistical significance (P =0.06). There was a significant difference in graft rate between the groups: at 3 years 72% of non-Asians versus 55% of Asians had been transplanted from the waiting list (P P P =0.07). Asian cadaveric donation was identified in 2 of 608 transplants during a 10-year period. Conclusion. Asian patients gained access to the transplant waiting list at a similar rate to the non-Asian white majority. Because of difficulties with HLA matching, Asian patients were significantly disadvantaged in receiving a transplant once listed, and there was a trend towards reduced posttransplant survival. Cadaveric donation was uncommon from within the Asian community; the reasons for which are likely to be complex.