Original ArticleDisparities in Outcome for Black Patients after Pediatric Heart Transplantation
Section snippets
Methods
This study was carried out with approval from the Institutional Review Board of Children's Healthcare of Atlanta. Data for this analysis were supplied by UNOS. From 1987 to 2004 there were 4227 children, ages 17 years or younger, who underwent heart transplantation. The data set consisted of the Transplant Candidate Registration form and Transplant Recipient Registration form, and the Transplant Recipient follow-up form. The follow-up form was administered annually.
To explore the relationship
Results
During the study period 4227 heart transplants were studied. There were 4008 primary transplants and 219 repeat transplants for subjects with prior graft failure. Of the 4227 pediatric heart transplant recipients, 717 (17%) were black. The median age at transplantation for the entire cohort was 3 years. The 2 most common indications for transplantation were congenital heart disease in 2032 (48%) and dilated cardiomyopathy in 1163 (28%). The freedom from graft failure for the entire cohort was
Discussion
This study demonstrates that black children who undergo heart transplantation have significantly lower graft survival rates when compared with recipients of other races. In this large cohort covering more than 16 years of the pediatric transplantation experience, the median graft survival after heart transplantation in black children was 5.3 years compared with 11.0 years for other recipients. These differences do not appear to be related to disparities in household income or insurance status.
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