Related Experiment Video
Updated: Aug 14, 2026
A Modified Method for Heterotopic Mouse Heart Transplantion
Published on: June 23, 2014
Disparities in outcome for black patients after pediatric heart transplantation
William T Mahle1, Kirk R Kanter, Robert N Vincent
1Department of Pediatrics, Division of Cardiology, Emory University School of Medicine, Atlanta, Ga 30322-1062, USA. wmahle@emory.edu
Insights
Black children undergoing heart transplantation have significantly lower graft survival rates compared to other racial groups. These disparities persist even after accounting for socioeconomic factors, indicating a complex issue in pediatric heart transplant outcomes.
Area of Science:
- Pediatric cardiology
- Transplant immunology
- Health disparities research
Background:
- Graft survival is a critical metric in pediatric heart transplantation.
- Understanding racial disparities in transplant outcomes is essential for equitable care.
Purpose of the Study:
- To investigate the association between Black race and graft survival in pediatric heart transplant recipients.
- To identify factors contributing to potential differences in outcomes.
Main Methods:
- Analysis of United Network for Organ Sharing data for pediatric heart transplant recipients (1987-2004).
- Utilized proportional hazards regression to control for confounding variables.
- Examined graft survival rates, human leukocyte antigen (HLA) mismatches, and socioeconomic factors.
Main Results:
- Black recipients (17%) had significantly lower 5-year graft survival (51% vs. 69%) and median survival (5.3 vs. 11.0 years).
- Black recipients exhibited more HLA mismatches, lower income, and higher reliance on Medicaid.
- Even after adjusting for economic factors, Black race remained a significant predictor of graft failure (OR=1.67).
Conclusions:
- Black children experience substantially reduced median graft survival post-heart transplantation.
- Disparities in pediatric heart transplant outcomes for Black recipients are not primarily driven by economic factors.
Objective:
To examine the relationship of black race to graft survival after heart transplantation in children.
Study Design:
United Network for Organ Sharing records of heart transplantation for subjects <18 years of age from 1987 to 2004 were reviewed. Analysis was performed using proportional hazards regression controlling for other potential risk factors.
Results:
Of the 4227 pediatric heart transplant recipients, 717 (17%) were black. The 1-year graft survival rate did not differ among groups; however, the 5-year graft survival rate was significantly lower for black recipients, 51% versus 69%, P < .001. The median graft survival for black recipients was 5.3 years as compared with 11.0 years for other recipients. Black recipients had a greater number of human leukocyte antigen mismatches, lower median household income, and a greater percentage with Medicaid as primary insurance, P < .001, P < .001, and P < .001. After adjusting for economic disparities, black race remained significantly associated with graft failure, odds ratio = 1.67 (95% CI 1.47 to 1.87), P < .001.
Conclusions:
Median graft survival after pediatric heart transplantation for black recipients is less than half that of other racial groups. These differences do not appear to be related primarily to economic disparities.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...