Abstract
Introduction: The immune function assay (IFA) is used in transplant recipients to measure the degree of lymphocyte-mediated cell immunity. Values <225 ng/mL are associated with an increased risk of infection and it is uncertain if race/ethnicity associates with differences in IFA values after heart transplantation. We tested the association between ethnicity/race with IFA results for heart transplant recipients for the first year after transplantation. Methods: A single-center cohort study of consecutive heart transplant recipients from 1/1/2014-8/31/2022 with an IFA obtained within 30-days prior to heart transplant and > 1 assay within the first year afterwards. We described the change of IFA in 90-day increments by self-reported race/ethnicity. Multivariable logistic regression models tested the association of patient-level clinical factors (age, sex, race, ethnicity, BMI, creatinine) with IFA values <225 ng/mL. Results: In the cohort, (121/315) (38%) had an IFA within 30-days prior to heart transplant. Most patients were white (46%), and male (74%). All groups had decreases in IFA value post-transplant. White non-Hispanic patients had changes of -64, -131, -143, and -107 in IFA, respectively. White Hispanic patients had changes of -117, -119, -58, and -72. Asian patients had changes of -250, -241, -102, and -260. Black patients had changes of -95, -87, -118, and -113. Black patients had the greatest prevalence of an immune assay <225 ng/mL during days 270-360 after transplantation. White non-Hispanic, White Hispanic, and Asian patients had the greatest prevalence of an IFA <225 ng/mL 90-180 days after transplantation. In our adjusted models, race was not associated with IFA values <225 ng/mL during any quarter within the first year after transplant (P >0.05). Conclusion: In this small study, non-white heart transplant patients on average had lower IFA values over the first-year post-transplant compared with white non-hispanic patients.
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