Characterizing Middle Eastern and North African Patients in US Transplant Data.

BACKGROUND: The Office of Management and Budget's March 2024 Statistical Policy Directive 15 revision requires reporting Middle Eastern or North African (MENA) individuals separately from the White category. This study compares MENA and non-MENA transplant candidates/recipients before the revision to determine whether differences exist between these populations. METHODS: We analyzed Organ Procurement and Transplantation Network (OPTN) single-organ kidney, liver, heart, and lung registrations ever-waiting or transplanted between January 1, 2018, and June 30, 2023, filtering to White, non-Hispanic (NHW) US residents. Individuals reporting Arab/Middle Eastern and North African race/ethnicity were classified as MENA. Demographics, 1-y Kaplan-Meier graft/patient survival, transplant and waitlist mortality rates, and median time to transplant (based on cumulative incidence) were calculated. RESULTS: MENA registrations were younger (7.0% versus 3.3%; <18 y), more frequently male (71.4% versus 63.8%), and more commonly kidney candidates (70.1% versus 59.7%), on public/charity insurance (60.6% versus 48.8%). MENA kidney registrations had longer median dialysis time at listing (154 versus 47 d) compared with non-MENA registrations. Larger proportions of MENA liver registrations were listed under the least medically urgent statuses, while larger proportions of MENA thoracic registrations were listed under more medically urgent statuses. Median time to transplant was longer for MENA versus non-MENA liver registrations (662 versus 443 d), and shorter for MENA versus non-MENA thoracic registrations (64 versus 83 d). One-year graft/patient survival was similar (eg, liver recipients: 0.95 versus 0.94). Transplant and waitlist mortality rates were lower for MENA versus non-MENA liver candidates (69.4 versus 89.2 deceased donor transplants (7.0 versus 11.0 waitlist deaths) per 100 active or total patient-years, respectively). CONCLUSIONS: Dialysis time at listing, medical urgency distributions, waitlist mortality rates, transplant rates, and median time to transplant differed between MENA and non-MENA candidates. As more data accrue, separate monitoring of MENA candidates/recipients may further elucidate the waitlist and transplantation experience of these individuals.

Duke Scholars

Author Lisa M McElroy Surgery, Abdominal Transplant Surgery