Evaluating the intersectionality of race and gender and its impact on heart transplant equity, listing outcomes, and allocation policy
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View abstract on PubMed
Summary
This summary is machine-generated.Black patients experienced decreased odds of heart transplantation (HTx) compared to White patients. Female recipients showed improved survival rates on the HTx waitlist, indicating ongoing disparities.
Area Of Science
- Cardiology
- Transplant Surgery
- Health Disparities Research
Background
- Existing research on race and gender disparities in heart transplantation (HTx) often examines these factors independently.
- Few studies have investigated the intersectional impact of race and gender on HTx waitlist outcomes.
Purpose Of The Study
- To investigate the intersectionality of race and gender and its effect on heart transplantation waitlist outcomes.
- To analyze disparities in transplantation rates and mortality among different racial and gender groups.
Main Methods
- Analysis of adult patients listed for orthotopic heart transplantation (HTx) between 2010 and 2023 using the United Network for Organ Sharing database.
- Inclusion of White and Black patients, excluding those with missing race/gender data, prior HTx, or concurrent listings.
- Categorization into four groups (White-male, White-female, Black-male, Black-female) and use of competing-risk models to assess waitlist outcomes (transplantation and death).
Main Results
- The study included 37,796 patients: 55.1% White-male, 17.4% White-female, 18.6% Black-male, and 8.9% Black-female.
- Black-male and Black-female patients had significantly lower odds of receiving a transplant compared to White-male patients (HR=0.86 and HR=0.82, respectively; p<0.001).
- Both female groups (White-female and Black-female) exhibited decreased mortality risk on the waitlist compared to White-male and Black-male patients.
Conclusions
- Persistent racial disparities exist in heart transplantation (HTx), with Black patients facing reduced odds of receiving transplants.
- Female patients demonstrated superior survival rates while on the HTx waitlist.
- While recent policy changes show marginal improvements for some groups, further efforts are necessary to ensure equity in the heart transplant allocation system.
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