17 May Heart Transplantation Outcomes: Racial Disparities Exist But Narrowing

MedicalResearch.com Interview with:

Dr. Fuery

Michael Fuery, MD
Department of Internal Medicine
Yale School of Medicine

Dr. Clarke

Katherine Clark, MD MBA
Division of Cardiovascular Medicine
Department of Internal Medicine
Yale School of Medicine

MedicalResearch.com: What is the background for this study?  

Response: Racial and ethnic disparities affect cardiac transplantation outcomes. In cohort analyses of racial and ethnic groups from the previous three decades, Black patients were constantly at a higher risk of mortality after cardiac transplantation. In 2018, the United Network for Organ Sharing (UNOS) revised the allocation system to expand access to organs for the most medically urgent patients and reduce disparities and regional differences. We sought to evaluate contemporary trends and impact of the new 2018 allocation system.

MedicalResearch.com: What are the main findings?

Response: Black and Hispanic patients were younger, more significantly likely to be female and have a history diabetes and renal disease, while white patients were more likely to have a history of previous cardiac surgery. Over the study period, the proportion of Black and Hispanic patients listed for transplant increased: 22% to 28% and 8% to 9.0%, respectively. As compared with white patients, Black patients were significantly less likely to undergo transplantation, but significantly more likely to have post-transplantation death. There were no differences in the proportion of transplanted patients or post-transplant deaths for Hispanic patients compared to white patients. Following the allocation system change, rates of transplantation increased for all groups, but Black patients still had a significantly lower likelihood of transplantation than white patients.

MedicalResearch.com: What should readers take away from your report?

Response: Although the proportion of Black and Hispanic patients listed for cardiac transplantation have increased, significant disparities remain. Compared to white patients, Black patients were less likely to be transplanted, even with improvements to access with the new allocation system and had a higher risk of post-transplantation death. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Given the multifactorial causes of disparities, multiple solutions have been suggested: increased minority enrollment in clinical trials, expanding academic-community partnership, and increased diversification of the healthcare work force. To fully eradicate these disparities in cardiac transplantation, it will be necessary to address societal policies as well. Future studies are needed to delineate the impact of these many factors on outcomes for Black patients undergoing heart transplantation.

No relevant disclosures.

Citation:

ACC21 abstract:

An Evaluation Of Racial Disparities In Heart Transplantation Outcomes

[last-modified] 

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Last Updated on May 17, 2021 by Marie Benz MD FAAD