Abstract：
African-American (AA) has historically been associated with inferior graft survival after pancreas transplantation. However, with the improvement of immunosuppression and surgical technique, we hypothesized that the racial disparity has been neutralized.
We analyzed data from the Scientific Registry of Transplant Recipients (1989-2018). Using Kaplan-Meier estimation and Cox proportional hazards regression, we examined the influence of race on pancreatic graft survival.
Before 2009, AA recipients had a higher risk of pancreatic graft failure after adjusting for confounding factors (hazard ratio [HR]: 1.16, 95% confidence interval [CI]: 1.08-1.24), but the risks for Hispanic and Asian recipients were both comparable to their Caucasian counterparts. However, the risk of pancreatic graft failure in AA recipients dropped to 1% and was no longer significant since 2009 (HR: 1.01, 95%CI: 0.88-1.16). Interestingly, donor race showed similar results. Furthermore, the concordance statistic of the complete pancreas donor risk index (including donor race) was 0.582, whereas the concordance did not change when donor race was eliminated from the model.
AA and other races have shown similar pancreatic graft survival in the modern era. Furthermore, donor racial disparity also seems neutralized; thus, donor race should not be considered as an indicator of pancreatic donor quality.
We analyzed data from the Scientific Registry of Transplant Recipients (1989-2018). Using Kaplan-Meier estimation and Cox proportional hazards regression, we examined the influence of race on pancreatic graft survival.
Before 2009, AA recipients had a higher risk of pancreatic graft failure after adjusting for confounding factors (hazard ratio [HR]: 1.16, 95% confidence interval [CI]: 1.08-1.24), but the risks for Hispanic and Asian recipients were both comparable to their Caucasian counterparts. However, the risk of pancreatic graft failure in AA recipients dropped to 1% and was no longer significant since 2009 (HR: 1.01, 95%CI: 0.88-1.16). Interestingly, donor race showed similar results. Furthermore, the concordance statistic of the complete pancreas donor risk index (including donor race) was 0.582, whereas the concordance did not change when donor race was eliminated from the model.
AA and other races have shown similar pancreatic graft survival in the modern era. Furthermore, donor racial disparity also seems neutralized; thus, donor race should not be considered as an indicator of pancreatic donor quality.
摘要：
非洲裔美国人（AA）历来与胰腺移植后的下移植物存活有关。然而,随着免疫抑制和手术技术的提高，我们假设种族差异已经被抵消了。
我们分析了移植接受者科学登记处（1989-2018）的数据。使用Kaplan-Meier估计和Cox比例风险回归，我们研究了种族对胰腺移植物存活的影响。
在2009年之前，AA受者在校正混杂因素后，胰腺移植失败的风险更高（风险比[HR]：1.16，95％置信区间[CI]：1.08-1.24），但西班牙裔和亚裔接受者的风险均与其高加索人相当.然而,AA受者胰腺移植失败的风险降至1%,自2009年以来不再显著(HR:1.01,95CI:0.88~1.16).有趣的是,供体种族也显示了类似的结果.此外，完整胰腺供者风险指数(包括供者种族)的一致性统计为0.582,而当模型中排除供者种族时,一致性没有变化.
AA和其他种族在现代时代显示出类似的胰腺移植物存活率。此外，捐赠者的种族差异似乎也被抵消了；因此，供体种族不应被视为胰腺供体质量的指标.
我们分析了移植接受者科学登记处（1989-2018）的数据。使用Kaplan-Meier估计和Cox比例风险回归，我们研究了种族对胰腺移植物存活的影响。
在2009年之前，AA受者在校正混杂因素后，胰腺移植失败的风险更高（风险比[HR]：1.16，95％置信区间[CI]：1.08-1.24），但西班牙裔和亚裔接受者的风险均与其高加索人相当.然而,AA受者胰腺移植失败的风险降至1%,自2009年以来不再显著(HR:1.01,95CI:0.88~1.16).有趣的是,供体种族也显示了类似的结果.此外，完整胰腺供者风险指数(包括供者种族)的一致性统计为0.582,而当模型中排除供者种族时,一致性没有变化.
AA和其他种族在现代时代显示出类似的胰腺移植物存活率。此外，捐赠者的种族差异似乎也被抵消了；因此，供体种族不应被视为胰腺供体质量的指标.
