A Study of Characteristics, Waitlist Mortality and Successful Heart Transplantation By Race in Contemporary Era

Abstract

Background Longer wait time and poor outcomes after heart transplant (HT) have been reported among blacks and minor ethnic groups. Whether racial disparity exists in the utilization of mechanical circulatory support, waitlist mortality, and HT rates is unknown. Methods We identified the adult patients listed for HT between 2000 and 2018 in the Scientific Registry of Transplant Recipients. Recipient characteristics, including hemodynamic and biochemical variables, are compared between racial groups-blacks, Asians, and others. The patients were followed until death, transplant, or end of data availability. Waitlist mortality and successful HT were compared between racial groups using a Fine and Gray competing risk regression model adjusted for known risk factors. Results Of the 57,285 listings; 43,485 (75.9%) were whites; 11,640 (20.3%) were blacks; 1,547 (2.7%) were Asians and 613 (1.1%) were listed as others. Blacks were significantly younger, had higher BMI, non-ischemic cardiomyopathy, hypertension, renal dysfunction, and dialysis (Table). Although more blacks were listed with LVAD bridge vs. whites, ECMO utilization was significantly lower. In the 37,164 patients who received a successful HT, the median wait time to transplant was lower (p Conclusions Overall, waitlist mortality and successful transplantation rates were similar across racial groups. Black HT candidates were less likely to be bridged with ECMO compared with Whites. Asians had higher transplantation rates while supported on ECMO or IABP.