Aims:
  • To bring together experts in the field of kidney transplantation, infectious diseases and immunology to review outcomes of transplants in Indigenous Australians. 
Objectives:
  • To review the evidence, determine protocols, implementation guidelines, educational requirements and research gaps that will improve the outcomes of Indigenous Australians receiving kidney transplants.
Summary:

The meeting was held in Darwin on the 15 and 16 October 2013. The final attendee list consisted of 56 participants, 27 from interstate and included nephrologists, transplant nurses, immunologists, infectious diseases experts, two transplant surgeons and an Intesivist. A representative from the Transplant Authority also attended as did the TSANZ President.

The meeting focused on presenting the available evidence in order to compare and determine differences between jurisdictions for treatment protocols, management guidelines and educational requirements.

A number of evidence gaps were identified and attendees with a particular interest have continued to communicate and discuss the development of specific projects. Several small investigative projects that can be carried out with minimal funding have progressed.

Menzies will provide ongoing support in the form of coordination, communication, data management and assistance with ethics and funding applications as required for these groups.

Implications for policy and practice:

Kidney transplantation is widely accepted to be the best therapy for most individuals with end-stage kidney disease. However, transplant outcomes amongst Indigenous people are considerably poorer compared to non-Indigenous Australians. There is an urgent need for further investigation into factors that might contribute to this. 

Our research has found:

Indigenous Australians experience significantly worse outcomes following kidney transplantation compared with non-Indigenous Australians.

Much of this can be attributed to higher levels of comorbidities, lesser degrees of HLA matching and greater levels of sensitisation, but Indigenous Australians also have higher incidences of infection.

Indigenous recipients are more likely to experience serious infectious complications resulting in graft loss or death than non-Indigenous recipients. The reasons for this are still unclear. 

Chief investigator:
Project manager:
Contact information:
Project dates:

This project has been completed. (meeting summary available here)

Funders:
  • Australian and New Zealand Society of Nephrology (ANZSN)
  • The Thoracic Society of Australia and New Zealand (TSANZ)
  • Amgen
  • Novartis
Collaborators:
  • Professor Stephen McDonald - CNART
  • Dr William Majoni - NT Renal Services
  • Dr Kevin Warr – Royal Perth Hospital.

Presentations from the IKTO meeting are available online by contacting Gillian Gorham.