# Multifaceted Intervention to Improve Graft Outcome Disparities in African American Kidney Transplants (MITIGAAT)

> **NIH NIH R01** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2024 · $595,909

## Abstract

PROJECT SUMMARY
Compared to Caucasians, African American (AA) kidney transplant recipients have twice the risk of graft loss.
Despite recent studies demonstrating marginal improvements in access to transplant, a kidney transplanted
today functions about half as long in AA recipients as compared to Caucasians. Our formative research
demonstrates that in contemporary kidney recipients, several late (≥2 years) post-transplant clinical markers,
including acute rejection, high tacrolimus trough variability and sub-optimal control of hypertension and diabetes
can explain disparities in AAs. We completed a 60 patient prospective interventional pilot study demonstrating
significant improvements in the control of hypertension and diabetes through a technology-enabled intervention.
This study demonstrated that clinical improvements in hypertension control were more substantial in AAs. We
also completed two randomized controlled trials demonstrating that real-time medication adherence monitoring
is feasible and highly accepted within kidney recipients. This demonstrates a technology-based automated
medication monitoring system is a promising intervention to identify and prevent late medication non-adherence,
thus reducing high tacrolimus variability and the risk of late rejection. Based on this formative research, we
propose to conduct the Multifaceted Intervention to Improve Graft outcome disparities in African American
Kidney Transplants (MITIGAAT) study. The overarching hypothesis for MITIGAAT is that the increased burden
of late clinical events and comorbidity burden within AA kidney transplant recipients are the primary contributor
to disparities in graft survival and a multimodal intervention that achieves improved identification and
management of these issues will address this disparity. We will test this hypothesis through a rigorously
conducted large-scale, long-term, prospective, randomized, controlled clinical trial in kidney transplant recipients
aiming to demonstrate improved tacrolimus trough variability and control of hypertension and diabetes in those
randomized to the intervention arm, as compared to the control arm while reducing disparities in AAs. Our
secondary aim is to conduct a cost benefit analysis to demonstrate that the intervention reduces healthcare
utilization and associated costs; our exploratory aim is to measure the incidence of acute rejection and graft loss
in AA kidney recipients, comparing this between the intervention and a control cohort. The enduring goal of this
proposal is to demonstrate an effective, efficient, and feasibly deployable method to improve long-term outcomes
in AA kidney recipients while reducing health disparities.

## Key facts

- **NIH application ID:** 10877818
- **Project number:** 5R01DK134326-02
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** David J. Taber
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $595,909
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10877818

## Citation

> US National Institutes of Health, RePORTER application 10877818, Multifaceted Intervention to Improve Graft Outcome Disparities in African American Kidney Transplants (MITIGAAT) (5R01DK134326-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10877818. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*