Heart transplant

Despite progress, black patients are still unlikely to receive heart transplants

After multivariate adjustment, the risk ratio for transplantation in AA was 0.90 (95% CI 0.83 – 0.96) compared to Caucasians, and the time to transplantation for other minorities was not not long. Credit: DOI: 10.1161 /circ.138.suppl_1.17340

Blacks who need a new heart are less likely to receive a transplant than whites, and if they do, they are more likely to die later, according to a new study.

Study published Wednesday Journal of the American Heart AssociationAnalysis of the impact of changes made in 2018 on how port allocations are made to increase availability.

That year, the United Network for Organ Sharing (UNOS) overhauled its allocation system with the aim of improving access to organs for the sickest patients and reducing racial and regional disparities. Older systems could increase wait times for residents of populous and diverse cities, disproportionately affecting black and Hispanic beneficiaries.

Evidence of this situation was reported at the American Heart Association Scientific Conference in 2018. NS Preliminary investigation Between 2005 and 2016, it was suggested that black patients had longer wait times for heart transplants than other racial and ethnic groups.

In a new study, researchers analyzed the characteristics and outcomes of 32,353 cardiac recipients through UNOS data for nearly a decade from 2011 to 2020. They found that since the launch of the new transplant allocation system in 2018, black, hispanic and white patients generally spend less time on the wait list and are more likely to receive the heart.

However, some racial disparities remained.

Compared to their white counterparts, black patients were still 10% less likely to be transplanted. The researchers also found that black patients had a 14% higher risk of death after a 10-year transplant than white patients.

“We may be moving the needle in a more equitable direction, but at the same time, we still have work to do to meet our goal of delivering. Heart transplant Fairly to all patients who need it, ”said Dr. Sounok Sen, co-author of the study.

Sen, a cardiologist and assistant professor at the Yale School of Medicine in New Haven, Connecticut, said the study was observational and it was impossible to pinpoint the exact reason for the racial disparity. The study also raises the issue of racial bias among medical professionals, Sen said.

“This is what we know exists all over the world. Whether this affects transplants as well is a question we need to ask ourselves very carefully, ”he said. paddy field. “We have to look at each of our programs individually and at the local level as well. “

Sen said he hopes the new technology will increase access and improve the success rate of transplants for everyone. He pointed to “an organ care system often referred to as the heart in the box.” This prolongs the survival of the donor’s heart and allows it to travel further to obtain the appropriate organs.

He said another promising option would be a “post-cardiovascular donation”, or DCD, transplant. Transplantation.. This is when the registered donor is not officially brain dead, but has catastrophic and unsustainable neurological damage and withdraws from life support with the approval of the family. DCD transplantation is expected to significantly increase the donor pool in the future.

Dr Errol Bush, who was not on the study, said it was the first study to assess the change. Racial disparity Since then UNOS has revised the allocation system. He said the results show that “systemic racism” still exists when it comes to heart transplants.

“By focusing on these medical disparities, clinicians and policy makers can engage in dialogue, support investigations, and develop and implement solutions to reduce them,” said Surgery Associate. Bush, professor and surgical director of the Advanced Lung Disease and Lung Transplant Program, said. Johns Hopkins University in Baltimore.

He said the new study emphasizes the need to achieve equity in the world. heart Transplantation.

Communities that have historically been affected by systematic racism “need more resources to navigate complex health systems while engaging with each other to provide more vigilant care. “Maybe,” Bush said.


Racial Disparity: Young Black Adults Had Significantly Worse Heart Transplant Outcomes


For more information:
Anuradha Lala et al, Summary 17340: Differences in wait times for heart transplants between racial and ethnic minorities, circulation (2021). DOI: 10.1161 /circ.138.suppl_1.17340

Quote: Black patients (Aug 26, 2021) who are still unlikely to receive a heart transplant despite progress, https://medicalxpress.com/news/2021-08-black-patients-heart-transplants. Retrieved from html on August 26, 2021.

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Despite progress, black patients are still unlikely to receive heart transplants

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