High-Volume Centers Do Not Mitigate Heart Transplant Survival Disparity
TUESDAY, Oct. 22, 2024 -- Receiving a heart transplant (HT) at high-volume centers (HVCs) does not ameliorate the survival disparity between recipients who are most and least socioeconomically deprived, according to a study published online Sept. 30 in the Journal of Heart and Lung Transplantation.
Sara Sakowitz, M.P.H., from the University of California, Los Angeles, and colleagues assessed whether treatment at HVCs would mitigate the adverse impact of area deprivation on HT outcomes. The analysis included 38,022 HT recipients identified in the Organ Procurement and Transplantation Network (2005 to 2022).
The researchers found that 20 percent of the recipients were considered most deprived. The most deprived recipients showed inferior survival at three years (hazard ratio, 1.14) and five years after transplantation (hazard ratio, 1.13). Additionally, being most deprived was associated with greater graft failure at three (hazard ratio, 1.14) and five years (hazard ratio, 1.13). Even at HVCs, the most deprived recipients continued to face greater mortality at three and five years.
"Our study demonstrates that access to high-quality centers for cardiac transplantation does not mitigate persistent neighborhood deprivation-based disparities in patient and allograft survival," Sakowitz said in a statement. "Rather, factors outside the immediate posttransplantation period that stem from access to longitudinal care or crucial immunosuppressive medications, appear to be implicated."
Two authors disclosed ties to AtriCure and Edwards LifeSciences.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
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