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Invited Commentary

Nancy L. Ascher, MD, PhD
Arch Surg. 1997;132(1):40. doi:10.1001/archsurg.1997.01430250042008.
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This study represents a retrospective analysis of kidney transplantation outcome in a single center to ascertain the outcome risk in black recipients.

Black recipients demonstrated increasing poorer posttransplantation results than other recipients; this disparity reached almost 20% at 5 years after the transplantation.

This analysis identified 1 preoperative and 2 postoperative factors that predict poor graft outcome: cadaveric donor, dialysis due to acute tubular necrosis, and rejection. Black patients were disadvantaged because they received a higher proportion of cadaveric donors. Factors predicting the need for dialysis due to acute tubular necrosis were black recipient, male recipient, cadaveric donor, and peak PRA level greater than 30%. Factors predicting rejection were black recipient, male recipient, and current PRA level greater than 30%.

Although the authors suggest that these factors might be addressed individually to modify their effect, it is likely to be a complex matter. Through concerted efforts, cadaveric donation from the

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