Race, substance use, and evaluation for heart transplantation: Insights from a large urban medical center

IF 6.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Heart and Lung Transplantation Pub Date : 2024-05-17 DOI:10.1016/j.healun.2024.05.011

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引用次数: 0

Abstract

It is unknown whether racial disparities in access to heart transplantation (HT) are amplified when coupled with substance use. We examined patients evaluated for HT over 8 years at an urban transplant center. We evaluated substance use and race/ethnicity as independent and interactive predictors of HT and left ventricular assist device (LVAD) implantation. Of 1,148 patients evaluated for HT, substance use was cited as an ineligibility factor in 151 (13%) patients, 16 (11%) of whom ultimately received HT. Significantly more non-Hispanic Black (NHB) patients were deemed ineligible due to substance use (n = 59, 19%) compared to other races/ethnicities (non-Hispanic white: n = 68, 12%; other race/ethnicity: n = 24, p = 0.002). No racial differences were observed in the likelihood of HT among patients initially excluded for substances, but more NHB patients ultimately received LVAD than the other racial groups. This study encourages greater awareness of the role of substance use and race in the HT evaluation.

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种族、药物使用和心脏移植评估：一个大型城市医疗中心的启示

在接受心脏移植手术（HT）时，如果同时使用药物，种族间的差异是否会扩大，目前还不得而知。我们对一家城市移植中心 8 年来接受心脏移植评估的患者进行了调查。我们将药物使用和种族/民族作为心脏移植和左心室辅助装置（LVAD）植入的独立和交互预测因素进行了评估。在 1148 名接受过 HT 评估的患者中，有 151 名（13%）患者将药物使用作为不合格因素，其中 16 名（11%）患者最终接受了 HT。与其他种族/人种（非西班牙裔白人：n = 68，12%；其他种族/人种：n = 24，p = 0.002）相比，非西班牙裔黑人 (NHB) 患者因使用药物而被视为不符合条件的人数明显增多（n = 59，19%）。在最初因物质原因被排除的患者中，没有观察到使用 HT 的种族差异，但最终接受 LVAD 的非西班牙裔患者多于其他种族群体。这项研究促使人们进一步认识到药物使用和种族在 HT 评估中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Heart and Lung Transplantation 医学-呼吸系统

CiteScore

10.10

自引率

6.70%

发文量

1667

审稿时长

69 days

期刊介绍： The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.