title: Trends in wait-list mortality in children listed for heart transplantation in the United States: era effect across racial/ethnic groups.
abstract: We sought to evaluate trends in overall and race-specific pediatric heart transplant (HT) wait-list mortality in the United States (US) during the last 20 years. We identified all children <18 years old listed for primary HT in the US during 1989-2009 (N = 8096, 62% White, 19% Black, 13% Hispanic and 6% Other) using the Organ Procurement and Transplant Network database. Wait-list mortality was assessed in four successive eras (1989-1994, 1995-1999, 2000-2004 and 2005-2009). Overall wait-list mortality declined in successive eras (26%, 23%, 18% and 13%, respectively). The decline across eras remained significant in adjusted analysis (hazard ratio [HR] 0.70 in successive eras, 95% confidence interval [CI], 0.67-0.74) and was 67% lower for children listed during 2005-2009 versus those listed during 1989-1994 (HR 0.33; CI, 0.28-0.39). In models stratified by race, wait-list mortality decreased in all racial groups in successive eras. In models stratified by era, minority children were not at higher risk of wait-list mortality in the most recent era. We conclude that the risk of wait-list mortality among US children listed for HT has decreased by two-thirds during the last 20 years. Racial gaps in wait-list mortality present variably in the past are not present in the current era.
authors: Department of Cardiology, Children's Hospital Boston, Boston, MA, USA. TP.Singh@cardio.chboston.org
authors: T P
authors: TP
authors: Singh
authors: C S
authors: CS
authors: Almond
authors: G
authors: G
authors: Piercey
authors: K
authors: K
authors: Gauvreau
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D007223:Infant; D008297:Male; D044469:Racial Groups / Q000706:statistics & numerical data*; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D009927:Tissue and Organ Procurement; D014481:United States; D014850:Waiting Lists / Q000401:mortality*