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

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-08-30 DOI:10.1111/ctr.70290

Jason Cory Brunson, Johnny F. Jaber, Sravanthi Nandavaram, Amir Emtiazjoo, Borna Mehrad, Divya C. Patel, Diana Gomez-Manjarres

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引用次数: 0

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

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了解肺移植结果的种族差异：白人和西班牙裔患者的比较研究

西班牙裔/拉丁裔是美国人口中增长最快的群体。尽管人们已经认识到肺移植术后的种族和民族差异，但他们并没有完全理解。我们比较了西班牙裔/拉丁裔和非西班牙裔白人肺移植后的长期预后，目的是确定是否有任何差异可归因于特定的种族-民族影响。方法：我们使用2005年6月至2020年9月的UNOS/OPTN数据对首次肺移植受者进行回顾性队列研究。我们使用Kaplan-Meier曲线、匹配比较和半参数（Cox）比例风险模型比较了西班牙/拉丁裔和白人非西班牙裔受者移植后的全因死亡率，这些模型针对相关协变量进行了调整，并扩展到考虑时变效应和中心随机效应，并模拟了移植失败与其他原因死亡率的竞争风险。结果在所有研究变量均可获得的18915例移植受者中，93%自报为白人非西班牙裔，7.3%为西班牙裔/拉丁裔。与非西班牙裔白人相比，西班牙裔的短期和长期生存率相似（1年：90%对88%，p = 0.121； 5年：61%对58%，p = 0.190； 10年：37%对32%，p = 0.543）。然而，总体生存曲线（p = 0.037）和完全调整模型（aHR = 0.90, p = 0.047）表明西班牙/拉丁裔患者的预后更好（p = 0.037）。结论：尽管有一些移植前健康指标较差，但与非西班牙裔白人肺移植受者相比，西班牙裔/拉丁裔肺移植受者的长期肺移植后结果相似。

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

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.