Understanding Racial Disparities in Lung Transplant Outcomes: A Comparative Study of White and Hispanic Patients

Hispanic/Latino individuals are the fastest growing subset of the US population. Although racial and ethnic differences in outcomes following lung transplantation have been recognized, they are not entirely understood. We compared long-term post-lung transplant outcomes in Hispanic/Latino and White non-Hispanic recipients and aimed to determine whether any differences are attributable to a specific racial-ethnic effect.

We performed a retrospective cohort study of first-time lung transplant recipients using UNOS/OPTN data from June 2005 through September 2020. We compared all-cause mortality post-transplantation in Hispanic/Latino and White non-Hispanic recipients using Kaplan-Meier curves, matched comparisons, and semiparametric (Cox) proportional hazards models, which were adjusted for relevant covariates and extended to account for time-varying effects and center random effects, and modeled graft failure against the competing risk of other-cause mortality.

Of 18 915 transplant recipients for whom all study variables were available, 93% self-reported as White non-Hispanic, and 7.3% as Hispanic/Latino. Hispanics had similar short- and long-term survival compared to White non-Hispanics (1-year: 90% vs. 88%, p = 0.121; 5-year: 61% vs. 58%, p = 0.190; 10-year: 37% vs. 32%, p = 0.543). Nevertheless, overall survival curves (p = 0.037) and the fully adjusted model (aHR = 0.90, p = 0.047) suggested better outcomes among Hispanic/Latino recipients (p = 0.037).

Despite several pre-transplantation indicators of worse health, Hispanic/Latino lung transplant recipients have similar long-term post-lung transplantation outcomes when compared to White non-Hispanic recipients.