Higher Mortality Rates in Heart Transplant Patients from Low-Income Groups

The researchers relied on 2004-2022 data from the Organ Procurement and Transplantation Network (OPTN) to ascertain the number of adult heart transplant patients, and the Distressed Communities Index (DCI), which uses neighborhood factors such as unemployment, poverty level, median income and housing vacancies to measure community socioeconomic inequity. Of 36,777 heart transplant patients, 7,450 were from distressed communities.

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Study limitations include a lack of granular data such as laboratory values and operative times, unavailability of patient medication adherence for analysis, and an inability to identify transplant centers’ location or proximity to socioeconomically distressed communities.

Addressing Social Inequity Gap for Better Survival Rates Post Heart Transplantation

Structural community distress is linked with inferior survival following heart transplantation, with the disparity gap in outcomes widening since the 2018 Policy Change.

Further, the DCI should be integrated into risk-stratification models to prevent risk-averse transplantation strategies that would disproportionately affect under-served patients. Given the compounding ramifications of the COVID-19 pandemic, particularly on already vulnerable populations, the field of heart transplantation must directly confront expanding inequity in outcomes.

“While social determinants of health have long been recognized to both shape access to and outcomes following heart transplantation, lack of clear metrics to measure such inequity has limited the development of targeted interventions,” said Sara Sakowitz, a medical student at the David Geffen School of Medicine at UCLA who led the study.

“Our work demonstrates community-level socioeconomic distress is linked with inferior survival following heart transplantation, and further establishes this socioeconomic disparity gap is widening. Changes in policy are needed to address persistent inequities in access to health,” he said.

Reference :

1. Impact of Community Socioeconomic Distress on Survival Following Heart Transplantation – (https://journals.lww.com/annalsofsurgery/abstract/9900/impact_of_community_socioeconomic_distress_on.635.aspx)

Source: Eurekalert