Introduction: Racial disparities in access to and outcomes after kidney transplantation have been a widely discussed topic. More specifically, many studies have shown less access to listing and transplantation, and worse graft survival after kidney transplantation in African American patients compared to Caucasians.
In our institution, African Americans comprise the largest percentage of our listed and transplanted patients; 41% of our listed patients and 42% of our cadaveric kidney recipients are African Americans. Nationally, these percentages are 33% and 25% respectively.
Methods: We studied 1333 African American and Caucasian patients who were transplanted in our institution from 1/1/2005-12/31/2014.The primary end points of our study were differences in graft survival, patient survival, cause of graft loss, and incidence of rejection.  The secondary end points were differences in access to listing and transplantation.
Results:  We found no difference between African Americans and Caucasians in patient survival. We found lower graft survival in African Americans, but when we adjusted for socioeconomic status there was no difference between the two groups. However, the incidence of rejection was higher among African Americans throughout all socioeconomic levels.  Rejection was also more common as a cause for graft failure in African Americans than Caucasians.                                     We found no difference between the two groups in access to listing and transplantation

Discussion: The majority of studies have shown lower graft survival in African American compared to Caucasian kidney transplant recipients. In our institution we did not find any such difference when we compared similar socioeconomic groups. However, we did find lower graft survival in patients with lower socioeconomic status irrespective of race.