Black men face the lowest odds of receiving a donor heart offer from transplant teams, according to a new study published in JAMA. The research, led by Dr. Khadijah Breathett of Indiana University, reveals significant disparities in heart transplant acceptance rates based on race and gender.
The study analyzed data from the United Network for Organ Sharing (UNOS) for adults listed for heart transplants between October 2018 and March 2023. Researchers found that white women had the highest probability of having a donor heart accepted, followed by Black women, white men, and Black men.
The first offer acceptance rates were 17.5% for white women, 14.0% for Black women, 10.3% for white men, and 7.9% for Black men. Additionally, Black men required a median of 11 offers before acceptance, compared to just five for white women.
“These disparities persisted after adjusting for candidate-, donor-, and offer-level variables, possibly suggesting racial and gender bias in the decision-making process,” the study authors wrote.
The research highlights potential issues in the heart transplant allocation system, with transplant centers and their medical teams playing a crucial role in accepting or denying donor heart offers. Dr. Breathett’s team emphasized that “changes in the decision pathway to accept a donor organ are needed.”
While the current allocation system is set to change to a continuous distribution model, the study underscores the importance of addressing potential biases in the decision-making process. The findings call for more detailed analyses of these practices, including studies on social determinants of health and race-based differences in immune responses in organ transplantation.
See “Do Race, Sex Factor Into Who Has Donor Heart Offers Turned Down by Transplant Docs?” (March 25, 2024)
