title: Cardiac transplantation in African Americans: a single-center experience.
abstract: BACKGROUND
  In view of limited data on the subject of graft and patient survival differences between African American (AA) and non-AA heart transplant recipients, we reviewed our experience.
  
  
  OBJECTIVE
  There is a higher mortality among AA recipients compared with non-AA recipients after cardiac transplantation.
  
  
  METHODS
  The study included all AA patients who have received a heart transplant in our center since 1983. Stepwise Cox regression was used for covariates affecting the survival. The χ(2) test was employed to identify the effects of a mechanical assist device and pretransplant creatinine (Cr) on the outcomes in AA and non-AA patients. Kaplan-Meier curves were used to examine survival.
  
  
  RESULTS
  The average survival among AA recipients was 5.4 years, compared with 12 years for the non-AA recipients, with 1-, 5-, and 10-year survival rates of 80%, 55%, and 25%, respectively. This was found to be statistically inferior to the survival probabilities of 92%, 78%, and 58% for the non-AA group (P < 0.005). Based on stepwise Cox regression, the variables such as ethnicity (P < 0.05), pretransplant Cr (P < 0.05), presence of a mechanical assist device (P < 0.005), and United Network for Organ Sharing (UNOS) status at transplant (P < 0.05) independently predicted the outcomes. Kaplan-Meier analysis of pretransplant Cr level and survival showed that the AA group did significantly worse for all Cr classes.
  
  
  CONCLUSIONS
  There is a statistically significant difference in outcomes between AA and non-AA patients after cardiac transplantation. African American patients have decreased survival over a period of time. Pretransplant Cr, ethnicity, presence of a mechanical assist device, and UNOS status at transplantation are independent predictors of outcomes.
authors.affiliation: Department of Cardiology Sarver Heart Center, University of Arizona Medical Center, Tucson, Arizona.
authors.forename: Prakash Goutham
authors.initials: PG
authors.lastname: Suryanarayana
authors.forename: Hannah
authors.initials: H
authors.lastname: Copeland
authors.forename: Mark
authors.initials: M
authors.lastname: Friedman
authors.forename: Jack G
authors.initials: JG
authors.lastname: Copeland
mesh_terms: D000328:Adult; D001741:Black or African American; D000075202:Contraindications; D003404:Creatinine / Q000097:blood; D005260:Female; D016027:Heart Transplantation / Q000401:mortality*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003404:Creatinine