Death Rates Higher for Minority Children Awaiting Heart Transplant
WEDNESDAY Nov. 12, 2008 -- Minority children waiting for a heart transplant have a higher death rate than white youngsters, say researchers who analyzed eight years of data from the United Network of Organ Sharing.
During that period, ending in 2006, there were 3,299 children waiting for a heart transplant. Of those, 58 percent were white, 20 percent were black, 16 percent were Hispanic, 3 percent were Asian, and 3 percent were listed as other.
After they compensated for age, listing and health status, the researchers found that, compared to white children:
- Black children had a 60 percent greater risk of dying.
- Hispanic children were 50 percent more likely to die.
- Asians and others had a 100 percent to 130 percent higher death rate.
Socioeconomic factors explained only some of this increased risk among minority children, accounting for a third of the increased risk in blacks and 20 percent of the increased risk in Hispanics, the researchers said. After they further adjusted the data for health insurance and household income, the risk of death remained higher for all non-whites -- 40 percent higher for blacks and Hispanics and more than 100 percent higher for Asians and others. The researchers also found that children covered by Medicaid were 20 percent more likely to die while waiting for a transplant.
The study was expected to be presented Nov. 11 at the American Heart Association's annual scientific sessions, in New Orleans.
"We were interested in finding the risk factors for death while awaiting a heart transplant in children listed for transplant. We realized that if you simply divide them into two categories of white and nonwhite, those who weren't white had a higher risk of dying," lead author Dr. T. P. Singh, assistant professor of pediatrics at Harvard Medical School and a pediatric cardiologist with the Heart Failure and Transplant Service at Children's Hospital Boston, said in a heart association news release.
"It is possible non-white children deteriorated more rapidly after (transplant) listing or that those non-white parents preferred not to go to advanced therapies. The data raises these questions without providing answers," said Singh, who added that further studies are needed to determine the reasons why minority children are more likely to die while waiting for a heart transplant. Until there are clear answers, doctors taking care of children with heart failure need to be aware of these disparities, the study authors said.
The American Heart Association has more about heart transplants in infants and children.
Posted: November 2008
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