MP85-01 GRAFT OUTCOME DISPARITY IN A SINGLE RENAL TRANSPLANT CENTER BASED ON RECIPIENT GEOGRAPHIC ORIGIN

INTRODUCTION AND OBJECTIVES: The disparity in access to organs for kidney transplantation has led to inter-state “transplant tourism.” Our objective was to determine if recipients traveling over a state line for kidney transplantation experience different outcomes relative to recipients native to that state. METHODS: TheScientificRegistry of TransplantRecipientswas analyzed to examine all deceased donor kidney transplants performed from 1987-2014 (n1⁄41094). Those transplanted in their original state were labeled O (n1⁄4775). Those Nonnative recipients were labeled N (n1⁄4319). RESULTS: Demographics: Both sets of recipients received similar donor allografts except for the following (p-value<0.05): The N group received more DCD (6.9% vs 3.1%, p1⁄40.004) and CDC high-risk donors (19.4% vs. 7.6%, p<0.001), who were on average older (mean1⁄436.7 vs. 34.2, p1⁄40.016) and had a higher BMI (mean1⁄426.8 vs 25.8, p1⁄40.001). The N group had a shorter average cold ischemic time (mean1⁄416.6 vs. 19.1hours, p<0.001).HoweverDonorKDPImedianwas not different between groups (38% vs 35%, p1⁄40.478). Recipient demographics: TheN group containedmore Asians (5.6%vs0.3%, p<0.001), an older population (mean1⁄454.0 vs. 48.4, p<0.001) and fewer patients using Medicaid (0.7% vs 2.7%, p1⁄40.042). The N group also had more patients with a current PRA higher than 20% (22.8% vs 17.5%, p1⁄40.044) but fewer patients undergoing repeat transplantation (10.3% vs. 15.9%, P1⁄40.018). Outcomes: Patient survival was not statistically significantly different (mean time in years1⁄413.7 vs 12.9, p1⁄40.707). However, the N group experienced less delayed graft function (13.3% vs. 20.9%, P1⁄40.003), improved allograft survival (mean time in years1⁄417.1 vs 12.9, p<0.05) and a lower rate of retransplantation (3.2% vs. 13%, P<0.001). Log Rank test showed a significant difference in graft survival between education levels (p1⁄40.043). However, when analyzed with other possible risk factors in Cox Proportional Hazard test, education level was not an independent risk factor of graft failure (p1⁄40.153). Additionally, the incidence of rejection and rejection as a cause of graft loss were not statistically significantly different. CONCLUSIONS: In this single center study, those patients traveling from outside the state of transplantation (despite similar donor and recipient demographics) demonstrated superior allograft outcomes. These superioroutcomesmaybe tied tosocio-economic factorsyet tobeelucidated. Other confounding factors may exist to explain these discordant results.