Delivery of transplant care among Hmong kidney transplant recipients: Outcomes from a single institution

Marjorie Odegard, Oscar Serrano, Kent Peterson, Steven J Mongin, Danielle Berglund, David M Vock, Srinath Chinnakotla, Ty B. Dunn, Erik B Finger, Raja Kandaswamy, Timothy L Pruett, Arthur J Matas

Research output: Contribution to journalArticle

Abstract

Kidney transplantation entails well-coordinated complex care delivery. Patient-provider cultural and linguistic discordance can lead to healthcare disparities. We analyzed kidney transplantation outcomes among our institution's Hmong recipients using a retrospective cohort study. From 1995 to 2015, 2164 adult (age ≥18) recipients underwent kidney transplantation at our institution; 78 self-identified as Hmong. Survival rates were analyzed and compared to Caucasian recipients (n = 2086). Fifty (64.1%) Hmong recipients consistently requested interpreters. Mean follow-up was 9.8 years for both groups. Hmong recipients (N = 78) were on average younger at transplant (45.7 vs 49.7 years; P = 0.02), more likely to be female (56% vs 38%; P = 0.001), and had higher gravidity (5.0 vs 1.9 births; P < 0.001). There were 13 (16.7%) Hmong living donor recipients, who were younger (32.8 vs 42.9 years; P = 0.006) at transplant compared to Caucasians (1429, 68.5%). Hmong 1- and 5-year patient survival was 100%; Caucasians, 97.1% and 88% (P < 0.001). Hmong 1- and 5-year graft survival was 98.7% and 84.9%; Caucasians 94.8% and 80.9% (P = 0.013). One- and 5-year rejection-free survival showed no difference (88.9% vs 82.4%; 86.7% vs 83.4%, P = 0.996). Despite cultural and linguistic differences between Hmong recipients and providers, we found no evidence of inferiority in KT outcomes in the Hmong population.

Original languageEnglish (US)
Article numbere13539
JournalClinical Transplantation
Volume33
Issue number5
DOIs
StatePublished - May 1 2019

Fingerprint

Kidney Transplantation
Linguistics
Transplants
Kidney
Healthcare Disparities
Gravidity
Survival
Living Donors
Graft Survival
Cohort Studies
Survival Rate
Retrospective Studies
Parturition
Population
Transplant Recipients

Keywords

  • Hmong
  • cultural discordance
  • healthcare disparities
  • kidney transplantation
  • linguistic discordance
  • outcomes

PubMed: MeSH publication types

  • Journal Article

Cite this

Delivery of transplant care among Hmong kidney transplant recipients : Outcomes from a single institution. / Odegard, Marjorie; Serrano, Oscar; Peterson, Kent; Mongin, Steven J; Berglund, Danielle; Vock, David M; Chinnakotla, Srinath; Dunn, Ty B.; Finger, Erik B; Kandaswamy, Raja; Pruett, Timothy L; Matas, Arthur J.

In: Clinical Transplantation, Vol. 33, No. 5, e13539, 01.05.2019.

Research output: Contribution to journalArticle

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abstract = "Kidney transplantation entails well-coordinated complex care delivery. Patient-provider cultural and linguistic discordance can lead to healthcare disparities. We analyzed kidney transplantation outcomes among our institution's Hmong recipients using a retrospective cohort study. From 1995 to 2015, 2164 adult (age ≥18) recipients underwent kidney transplantation at our institution; 78 self-identified as Hmong. Survival rates were analyzed and compared to Caucasian recipients (n = 2086). Fifty (64.1{\%}) Hmong recipients consistently requested interpreters. Mean follow-up was 9.8 years for both groups. Hmong recipients (N = 78) were on average younger at transplant (45.7 vs 49.7 years; P = 0.02), more likely to be female (56{\%} vs 38{\%}; P = 0.001), and had higher gravidity (5.0 vs 1.9 births; P < 0.001). There were 13 (16.7{\%}) Hmong living donor recipients, who were younger (32.8 vs 42.9 years; P = 0.006) at transplant compared to Caucasians (1429, 68.5{\%}). Hmong 1- and 5-year patient survival was 100{\%}; Caucasians, 97.1{\%} and 88{\%} (P < 0.001). Hmong 1- and 5-year graft survival was 98.7{\%} and 84.9{\%}; Caucasians 94.8{\%} and 80.9{\%} (P = 0.013). One- and 5-year rejection-free survival showed no difference (88.9{\%} vs 82.4{\%}; 86.7{\%} vs 83.4{\%}, P = 0.996). Despite cultural and linguistic differences between Hmong recipients and providers, we found no evidence of inferiority in KT outcomes in the Hmong population.",
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