Patient Survival Following Renal Transplantation in Indigenous Populations: A Systematic Review.McGuire, C., et al. (2019).
Clinical Transplantation [record in progress].
This study aimed to evaluate patient survival and other post-transplant outcomes of kidney transplantation among indigenous patients compared with non-indigenous populations.
The MEDLINE, EMBASE, and Google Scholar database were searched for articles comparing survival of indigenous vs non-indigenous patients following renal transplantation.
Twelve retrospective studies examining inidiginous patients, published between 2004 and 2018 were included.
Primary outcomes being assessed in this systematic review include: patient survival, graft survival, and delayed graft function.
This is a well-conducted systematic review that highlights the differences in transplant outcomes between indigenous and non-indigenous populations. It included 12 studies and a good number of patients overall. Multiple databases were searched, following PRISMA guidelines and data extracted in duplicate. Included studies were assessed for quality and overall were of high quality. Meta-analysis was not possible due to non-standard outcomes however. Post-transplant outcomes including patient survival, rejection and graft loss were significantly worse amongst indigenous populations, and likely multifactorial. This paper provides a starting point for addressing these issues and does offer some discussion of ways forward. The outcomes presented here likely represent the inequality in delivery of healthcare to indigenous populations in several countries. However, the impact of modifiable risk factors, pre-existing comorbidities and time on the waiting list are also likely to be very important.