Racial and Ethnic Differences in Wait-List Outcomes in Patients Listed for Heart Transplantation in the United States
Background—Racial differences in long-term survival after heart transplant (HT) are well known. We sought to assess racial/ethnic differences in wait-list outcomes among patients listed for HT in the United States (US) in the current era.
Methods and Results—We compared wait-list and post-transplant in-hospital mortality among White, Black and Hispanic patients ≥18 yrs old listed for their primary HT in the US between July 2006 and September 2010. Of 10,377 patients analyzed, 71% were White, 21% Black and 8% were Hispanic. Black and Hispanic patients were more likely to be listed with higher urgency (listing status 1A/1B) compared to White patients (P<0.001). Overall, 10.5% of White, 11.6% of Black and 13.4% of Hispanic candidates died on the wait-list or became too sick to transplant within 1-yr of listing. After adjusting for baseline risk factors, Hispanic patients were at higher risk of wait-list mortality (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.23, 1.85) compared to White patients but not Black patients (HR 1.13, 95% CI 0.97, 1.31). Compared to White HT recipients, post-transplant in-hospital mortality was higher in Black recipients (Odds ratio [OR] 1.53, 95% CI 1.15, 2.03) but was not different in Hispanic recipients (OR 0.78, 95% CI 0.48, 1.29).
Conclusions—Hispanic patients listed for HT in the US appear to be at higher risk of dying on the wait-list or becoming too sick to transplant compared to White patients. Black patients are not at higher risk of wait-list mortality but have higher early post-transplant mortality.
- Received January 11, 2012.
- Accepted May 4, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited