title: Racial and ethnic differences in wait-list outcomes in patients listed for heart transplantation in the United States.
abstract: BACKGROUND
  Racial differences in long-term survival after heart transplant (HT) are well known. We sought to assess racial/ethnic differences in wait-list outcomes among patients listed for HT in the United States in the current era.
  
  
  RESULTS
  We compared wait-list and posttransplant in-hospital mortality among white, black, and Hispanic patients ≥ 18 years of age listed for their primary HT in the United States between July 2006 and September 2010. Of 10 377 patients analyzed, 71% were white, 21% were black, and 8% were Hispanic. Black and Hispanic patients were more likely to be listed with higher urgency (listing status 1A/1B) in comparison with white patients (P<0.001). Overall, 10.5% of white, 11.6% of black, and 13.4% of Hispanic candidates died on the wait-list or became too sick for a transplant within 1 year of listing. After adjusting for baseline risk factors, Hispanic patients were at higher risk of wait-list mortality (hazard ratio 1.51, 95% CI 1.23, 1.85) in comparison with white patients, but not black patients (hazard ratio 1.13, 95% CI 0.97, 1.31). In comparison with white HT recipients, posttransplant in-hospital mortality was higher in black recipients (odds ratio 1.53, 95% CI 1.15, 2.03) but was not different in Hispanic recipients (odds ratio 0.78, 95% CI 0.48, 1.29).
  
  
  CONCLUSIONS
  Hispanic patients listed for HT in the United States appear to be at higher risk of dying on the wait-list or becoming too sick for a transplant in comparison with white patients. Black patients are not at higher risk of wait-list mortality, but they have higher early posttransplant mortality.
authors.affiliation: Department of Cardiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA. TP.Singh@cardio.chboston.org
authors.forename: Tajinder P
authors.initials: TP
authors.lastname: Singh
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Almond
authors.forename: David O
authors.initials: DO
authors.lastname: Taylor
authors.forename: Carly E
authors.initials: CE
authors.lastname: Milliren
authors.forename: Dionne A
authors.initials: DA
authors.lastname: Graham
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D005260:Female; D016027:Heart Transplantation / Q000208:ethnology* / Q000401:mortality*; D006630:Hispanic or Latino; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States; D014850:Waiting Lists; D044465:White People; D001741:Black or African American