Donor and Recipient Racial Mismatch Impacts Thoracic Organ Transplant Survival

Abstract

Purpose The purpose of this study is to look at impact of race on thoracic organ recipient (TOR) survival with respect to the donor, recipient, and donor/ recipient matching. Methods The United Network for Organ Sharing (UNOS) database was retrospectively reviewed from 1/2000-3/2018 for donor hearts or lungs. After exclusions for multiorgan transplant and age (donor Results Donor age ranged from 15-77 y (mean 33.2y, median 31y). 66% were male, and 4% were diabetic. The mean donor ejection fraction (EF) was 60% (median 60%) and ischemic time ranged from 0.04-15 hours (h) for both heart and lungs (mean 4.00h, median 3.72h). There were 9914 (17%) AA, 9081 (15%) H, and 40003 (68%) W thoracic organ donors. Adjusted 30-day and 1 year survival of TORs was 96.2% and 87.7% from AA donors, 96.2% and 87.6% from H donors, and 96.5% and 89% from W donors. This equates to a 13% reduction in 1-year survival among AA and H donors when compared to W donors (both OR=0.87; p 0.068). AA exhibited lower long-term survival when compared to W (HR=1.12; p Conclusion While there is evidence of racial disparity in survival outcomes after thoracic organ transplant matched race donor/ recipient may improve thoracic transplant survival.