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Disparities in heart transplantation
Jane Y Zhao1, Matthew C Henn1, Nahush A Mokadam1
1Division of Cardiac Surgery.
Insights
Heart transplantation access and outcomes show persistent disparities for minority and lower socioeconomic status populations. Addressing these inequities requires further research and systemic changes for equitable end-stage heart failure treatment.
Area of Science:
- Cardiology
- Transplantation Medicine
- Health Equity
Background:
- Heart transplantation is the optimal treatment for end-stage heart failure.
- Significant barriers impede equitable access and influence outcomes in heart transplantation.
- Despite progress, disparities persist for racial/ethnic minorities and lower socioeconomic status groups.
Approach:
- This review synthesizes current and historical literature on heart transplantation disparities.
- It examines factors contributing to differential access and outcomes.
- The review identifies evidence gaps for future investigation.
Key Points:
- Disparities in heart transplantation are multifaceted, influenced by patient demographics, social factors, geopolitical issues, and provider bias.
- Progress in advanced heart failure therapies has not fully eliminated these inequities.
- Healthcare professionals must recognize and address these patient-facing disparities.
Conclusions:
- Persistent disparities in heart transplantation access and outcomes require urgent attention.
- Further research is essential to understand and mitigate these inequities.
- Systemic changes are necessary to ensure fair access to heart transplantation for all patients with end-stage heart failure.
Purpose Of Review:
Heart transplantation remains the gold standard therapy for end stage heart failure, but barriers remain, preventing equitable access to and affecting outcomes following transplantation. The objective of this review is to summarize current and historical literature on the disparities that persist, and to highlight the gaps in evidence for further investigation.
Recent Findings:
Although progress has been made to increase the rates of advanced heart failure therapies to racial/ethnic minority populations and those with lower socioeconomic status, differential access and outcomes remain. The disparities that persist are categorized by patient demographics, social influences, geopolitical factors, and provider bias.
Summary:
Disparities in heart transplantation exist, which span a wide spectrum. Healthcare professionals need to be cognizant of these disparities that patients face in terms of access to and outcomes for heart transplantation. Further research and system changes are needed to make heart transplantation a fairer option for patients of varying backgrounds with end stage heart failure.
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