Significant Differences in the Efficacy of Kidney Transplantation Between Hungarian Caucasians and Gypsies

• Published in: Transplantation proceedings Vol. 37; no. 2; pp. 729 - 730
• Main Authors: Langer, R.M., Hı́dvégi, M., Járay, J.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2005; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Continental Population Groups; Ethnic Groups; European Continental Ancestry Group; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - epidemiology; Histocompatibility Testing; Humans; Hungary; Kidney Transplantation - immunology; Kidney Transplantation - mortality; Kidney Transplantation - pathology; Kidney Transplantation - physiology; Medical sciences; Retrospective Studies; Roma; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Rate; Time Factors; Tissue, organ and graft immunology; Treatment Refusal; Hungary; Europe; Medicine; Treatment; Urinary system; Surgery; Treatment efficiency; Graft; Transplantation; Caucasoid; Homotransplantation; Comparative study; Kidney
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.12.190

In a retrospective study we examined the differences between Caucasian (Group A) and Gypsy (Group B) renal allograft recipients transplanted in Hungary. From 1983 to 2001, 1918 transplants were performed in Budapest (1825 Caucasian and 93 Gypsy recipients). Group B patients were younger (34 ± 12 vs 42 ± 14 years of age; P < .01) and Group A had more polycystic kidney disease (12% vs 3%; P < .025). Blood group B was more common in Group B (27% vs 19%; P = NS) than in Group A patients, and Group A had seemingly more diabetes (5% vs 1%; P = NS) than did Group B. There were no differences in HLA mismatches or panel reactive antibodies (PRA). No differences were seen in Group A vs Group B patient survivals at 1, 3, 5, or 10 years' posttransplant (98% vs 95%; 90% vs 93%; 85% vs 88%; and 74% vs 82%, respectively). However, Group A graft survivals were significantly better than Group B at 1, 3, 5, and 10 years' posttransplant (89% vs 77%; 82% vs 66%; 76% vs 54%; and 57% vs 34%; each comparison P < .01). Group B recipients experienced a greater number of acute rejection episodes (66% vs 49%; P < .01), irreversible acute rejections (15% vs 6%; P < .001), chronic rejections (34% vs 18%; P < .001), and graft loss due to immunosuppression noncompliance (5% vs 1%; P < .05) than did Group A recipients. As has been previously described for other non-Caucasian ethnic groups (eg, African-Americans), Hungarian Gypsies appear to be at a greater immunological risk for rejection and poorer long-term graft survival.