In South Florida the groups most often needing kidney transplants— African-Americans and Hispanics—have been the least likely to donate kidneys and the most likely to reject transplants. These disparities often prove detrimental, even deadly, for patients, says Gaetano Ciancio, M.D., associate director of the Division of Transplantation and director of transplant education and research for minority groups.

For the past ten years, Ciancio and a group of Miller School surgeons have been working to decrease rejection rates while pushing to increase kidney donations among Hispanics and African-Americans.

Ciancio says ethnic groups often have the same fingerprint common antigens, which can protect against chronic rejection. That’s why it’s so important to graft an African-American kidney into an African-American patient. By closely matching the DNA, doctors are reducing the risk of rejection.

When Ciancio began rotations in 1993, he focused much of his work on African-American and Hispanic patients. The task was daunting. Few matches could be found, and rejection rates soared to 20 to 30 percent.

He has helped to reduce those numbers significantly. The key, he found, is to use a group of agents that help reduce the chance of rejection. These include daclizumab, mycophenolate mofetil, tacrolimus, and steroids.

Over the past ten years, UM doctors have used these and other agents to helpmore than 3,000 kidney transplant recipients. Rejections steadily diminished. “Now they are in single digits, maybe 8 to 9 percent,” Ciancio says.

Thirty-year-old O.T. Patrick Jr. received a transplant in 2003 from Ciancio after living with kidney failure for more than a year. He has had type 1 diabetes since age 7 and admits he did not present himself as an ideal patient in the beginning.

“I had a terrible attitude,” Patrick recalls. “Dr. Ciancio sat down with me andbroke it down for me piece by piece.”

The transplant went very smoothly, and Patrick said he felt better in just a few days. “I had much more energy, my appetite came back.”

Perley Richardson, 50, has been living successfully with a transplant for 11 years. “Before that, I had been on dialysis for one year,” he says. “It was hard to breathe, hard to sleep.”

The side effects of the medication are minimal. “It’s better than dialysis,”Richardson says.

Cost is often a factor. The average monthly cost for the anti-rejection medications is $3,000, and many of the patients are uninsured. Ciancio works hard to convince drug companies to supply the meds to patients at no cost. So far, his tenacity is working, and it’s uniting the community.

Ciancio has appeared on TV and radio to talk about the subject, and the community honored him with the Dr. Martin Luther King Junior Spirit Awardin 2002.

But his work is just beginning. Ciancio hopes to create a University chair to continue his research and says he has no plans to change the focus or location of his work.

“I will stop only when access is the same among all ethnic groups,” he says. “Until the disparity is no longer there, I will be there.”