TY - JOUR
T1 - Race, substance use, and evaluation for heart transplantation
T2 - Insights from a large urban medical center
AU - Chuzi, Sarah
AU - Cabrera, Elizabeth
AU - Ilonze, Onyedika
AU - Vela, Alyssa
AU - Pifer, Lindsay
AU - Wu, Tingqing
AU - Baldridge, Abigail S.
AU - Harap, Rebecca
AU - Youmans, Quentin
AU - Ghafourian, Kambiz
AU - Tibrewala, Anjan
N1 - Publisher Copyright:
© 2024 International Society for the Heart and Lung Transplantation
PY - 2024/9
Y1 - 2024/9
N2 - 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.
AB - 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.
KW - disparities
KW - health equity
KW - heart transplantation
KW - left ventricular assist device
KW - substance use
UR - http://www.scopus.com/inward/record.url?scp=85194943463&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85194943463&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2024.05.011
DO - 10.1016/j.healun.2024.05.011
M3 - Article
C2 - 38763406
AN - SCOPUS:85194943463
SN - 1053-2498
VL - 43
SP - 1521
EP - 1524
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
IS - 9
ER -
