Racial disparities in Pacific Islanders undergoing renal transplant evaluation.

Pacific Islanders currently comprise 35% of all end-stage renal disease patients in Hawai'i but a much smaller proportion of those who undergo renal transplant. The purpose of this study to determine the reasons for such a disparity. In this retrospective review of 207 patients who were referred for renal transplant evaluation, 18.8% were Pacific Islanders. Patients attended a kidney transplant class, were offered evaluation and were placed on the waiting list if deemed appropriate. Of patients that were eventually placed on the list, 18.6% were Pacific Islander. There was no difference in age, gender body mass index, presence of diabetes, number with potential living donors, dialysis status, time from the referral to attending class and the time from the class to listing between Pacific Islanders and other ethnic groups. Pacific Islanders who are referred to our transplant program are able to make it through the evaluation and be listed with the same success as other patients. The problem in racial disparities in Hawai'i involves referral to the transplant center. Whether the problem of referral is due to other medical comorbidities or noncompliance is not clear and will require further investigation.

Cardiac transplantation in Hawai'i: a summary of the first 21 years.

Between 1987 and 2008, 45 patients have undergone cardiac transplantation in Hawai'i. This article summarizes the authors' experiences with cardiac transplantation over this 21-year period. The cumulative 1-, 3- and 5-year survival rates after transplantation have been 73.8%, 70.0%, and 63.2%, respectively. The corresponding survival rates have improved over the last eight years and are now 90.0%, 87.5%, and 83.3%, respectively. Despite clinical improvements, low patient volumes make the maintenance of a state-based program in Hawai'i difficult. Problems with financing and referral biases will need to be addressed if a local program is to continue.