Racial and Ethnic Disparities Persist in the Current Era of Pediatric Heart Transplantation
Section snippets
Study Population
All pediatric patients (age <18 years) listed for primary heart transplantation in the national Scientific Registry of Transplant Recipients (SRTR) database from December 16, 2011 (date of FDA approval of Berlin EXCOR), to February 28, 2019, were included in this study. We excluded patients listed for heart-lung transplantation (n = 43), lung transplantation (n = 394) and retransplantation (n = 243).
SRTR Database
The SRTR data system includes data for all donors, waitlist candidates and transplant recipients
Waitlist Cohort
A total of 4089 pediatric patients listed for heart transplantation were included in our analysis. Of these, 2134 (52.2%) were Caucasian, 840 (20.5%) African American, 808 (19.8%) Hispanic, 161 (3.9%) Asian, and 146 Other (3.6%). From 2012 to 2018, the relative percentage of children from various races and ethnicities listed for heart transplantation remained the same, except in 2014, 2015 and 2017, when there were more Hispanic than African American children (Fig. 1).
Differences in Characteristics Among Children of Differing Races/Ethnicities at Listing
The majority of children
Discussion
There are 3 important findings in our contemporary analysis of pediatric candidates listed for heart transplantation in the U.S. First, African American children listed for heart transplantation in the current era have higher severity of illness at listing and at transplantation. Second, in the current era of rising VAD use in children with advanced heart failure, African American children continue to experience higher waitlist mortality than Caucasian children. Finally, although early and
Acknowledgments
The data reported here have been supplied by the Hennepin Healthcare Research Institute as the contractor for the SRTR. SW and WL had full access to the data in the study and take responsibility for the integrity of the data and the accuracy of the analysis. All authors contributed to the design, interpretation of data and drafting of the manuscript along with revisions and participated in the final approval of the manuscript submitted. The interpretation and reporting of these data are the
Disclosures
Dr. Hsich is supported in part by HL141892 from the National Institute of Health. No other authors have any disclosures to report.
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