在目前的器官分配政策下，黑人种族与心脏移植术后短期生存率的提高有关。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-07-01 DOI:10.1016/j.transproceed.2025.05.035

Michael Zhu , Charley Sun , Patrick Warner , Masashi Kawabori , Yong Zhan

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引用次数: 0

摘要

目的：调查2018年引入新的联合器官共享网络（UNOS）分配政策后，心脏移植术后死亡率的种族差异是否仍然存在。方法：从UNOS数据库中确定2018年10月至2023年1月期间所有成人心脏移植（HTX）受者。比较黑人和白人受者的供体和受者特征。并比较两种族患者倾向评分匹配（PSM）前后的临床结果。结果：共有7325名白人和2865名黑人首次孤立接受HTX治疗。PSM确定了2862对收件人。黑人接受者的30天死亡率较低(1.8% vs 3.2%；P = .001)和180天死亡率(5.6% vs 7.0%；P = .043)；然而，黑人和白人受体的1年死亡率无显著差异(7.7% vs 8.7%；P = .164)。多变量分析显示，黑人种族与较低的30天死亡风险显著相关(风险比，0.73；95%置信区间为0.54-0.98；P = .037)。结论：在新的分配政策下，黑人HTX受助人短期死亡率较低；然而，黑色HTX受体的生存优势似乎随着时间的推移而消失。HTX中这种新的差异模式值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Black Race Is Associated With Improved Short-Term Survival After Heart Transplantation Under the Current Organ Allocation Policy

Objective

To investigate whether racial disparities in mortality after heart transplantation remain after introduction of the new United Network for Organ Sharing (UNOS) allocation policy in 2018.

Methods

All adult heart transplant (HTX) recipients between October 2018 and January 2023 were identified from the UNOS database. Donor and recipient characteristics were compared between black and white recipients. Clinical outcomes also were compared between the 2 racial groups before and after propensity score matching (PSM).

Results

A total of 7325 white and 2865 black recipients of isolated first-time HTX were included. PSM identified 2862 pairs of recipients. Black recipients had lower 30-day mortality (1.8% vs 3.2%; P = .001) and 180-day mortality (5.6% vs 7.0%; P = .043); however, 1-year mortality was not significantly different between black and white recipients (7.7% vs 8.7%; P = .164). Multivariate analysis revealed the black race was significantly associated with a lower risk of 30-day mortality (hazard ratio, 0.73; 95% confidence interval, 0.54-0.98; P = .037).

Conclusion

Under the new allocation policy, black HTX recipients have lower short-term mortality; however, the survival benefit of black HTX recipients appears to dissipate over time. This new pattern of disparities in HTX warrants further investigation.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.