Racial difference in renal transplant outcome of insulin-dependent diabetic recipients in the cyclosporine era

In an attempt to analyze the influence of race on renal allograft outcome among insulin-dependent diabetic uremics, all 109 cyclosporine treated transplant were studied. Black recipients were noted to have inferior 1 year survival for both living related and cadaver donor grafts when compared with both whites and Hispanics (67% and 43% vs. 92% and 84%, 100% and 80%, respectively, p < 0.01). Nonimmunologic causes accounted for 69% of graft losses among blacks, compared with 39% and 33% in whites and Hispanics, respectively. Among long-term survivors, however, renal function remained relatively stable among all racial groups. This differing trend among black diabetic recipients suggests the need for aggressive cardiac workups before transplantation, and judicious immunosuppression in the posttransplant period.