A racial gap in kidney transplants appears to have closed, a 13-year study found.
Rates of such transplants among white patients used to far surpass those in blacks, but U.S. data on nearly 200,000 end-stage kidney disease patients shows that disparity had disappeared by 2010. Rates remained stable in 2011 and that trend likely has continued, said Dr. Jesse Sammon, the senior author and a urologist-researcher at the Henry Ford Health System in Detroit.
The rate among black patients climbed from 93 per 1,000 patients in 1998 to about 128 per 1,000 patients in 2010 and 2011. That was also the 2010-11 rate for whites, a slight decline from 1998.
The trend among blacks was "driven wholly by increased rates of transplants from deceased donors," the study authors said. About 80 percent of operations in blacks in 2011 were cadaver organs, which tend to fare worse than those from living donors.
So while the study is mostly "good news," more work is needed to eliminate racial disparities among kidney transplant recipients, Sammon said.
The study was published Monday in JAMA Internal Medicine.
"This is what we've been working for years, to make sure we have equitable access to every potential candidate across the United States," said Dr. Mark Aeder, chairman of the United Network for Organ Sharing' kidney committee. He was not involved in the research.
The trend likely stems from a 2003 change in a national allocation policy for donor kidneys which eased a restriction on certain partially matched donor kidneys. Transplants have the best chance of success when donor organs contain certain proteins that completely match those of the recipient. Perfect matches are most likely when donors and recipients are the same race, but transplants involving partial matches also can work.
Wireless pacemaker could be surgery-free option
A tiny, wireless pacemaker could offer some heart patients a surgery-free alternative to the traditional devices, a new study says. Some doctors, however, say there are lingering safety questions and warned patients not to rush to get the new technology.
Unlike traditional pacemakers - which need a generator and wires and are implanted via surgery - the new pacemaker is a wireless tiny tube that can be attached to the right side of the heart using a catheter inserted through the leg.
"This is another landmark in the development of pacemakers," said Dr. Christopher Granger of the American Heart Association, who was not part of the new study. Still, he said doctors need time to learn how to use any new technology to avoid potential problems.
"I would tell patients to be careful of being one of the first to get this unless there's a compelling reason," he said.
In the new research, doctors in Australia, Canada and the U.S. implanted the mini-pacemaker into more than 500 people. After six months, nearly 7 percent of patients reported side effects including the device poking holes in their heart. In comparison, about 10 percent of patients who get regular pacemakers suffer complications.
The study was published online Sunday in the New England Journal of Medicine and is being presented at a meeting of the European Society of Cardiology in London. The research was paid for by the pacemaker's manufacturer, St. Jude Medical.
The miniature pacemaker is already approved in Europe and the new study will likely be submitted to the U.S. Food and Drug Administration.