African American renal transplant recipients (AARTRs) have higher rates of acute rejection episodes and lower rates of survival compared to Caucasian renal transplant recipients (CRTRs). A single-center, retrospective chart review of 114 consecutive adult renal transplant recipients was conducted at Westchester Medical Center, Valhalla, New York. Data were analyzed for the 27 AARTRs and 87 CRTRs receiving sirolimus (SRL), tacrolimus (TRL), and corticosteroid. The AARTR group received more cadaver organs (63%) compared to the CRTR group (40%) (P < 0.05). The mean doses of SRL and TRL were higher in the AARTR group, whereas the SRL and TRL trough levels were similar. The 6-month rejection-free graft survival rate was similar between AARTRs and CRTRs (67% and 74%, respectively). However, the 6-month patient survival rates were lower in AARTRs compared to CRTRs (82% and 95%, respectively; P < 0.05). SRL and TRL offer a safe combination for controlling acute rejection episodes without increased adverse events in the African American patient population. However, long-term patient survival continues to be lower in AARTRs than in CRTRs.
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