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The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.

Children from socioeconomically disadvantaged communities present in more advanced heart failure at the time of transplant listing

  • Shahnawaz Amdani
    Correspondence
    Reprint requests: Shahnawaz Amdani MD, FACC, Division of Cardiology, Pediatric Heart Failure and Transplant Cardiologist, Cleveland Clinic Children's Hospital, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH 44195.
    Affiliations
    Department of Pediatric Cardiology, Cleveland Clinic Children's, Ohio
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  • Anne Tang
    Affiliations
    Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio

    Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
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  • Jesse D. Schold
    Affiliations
    Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio

    Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
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Published:September 17, 2022DOI:https://doi.org/10.1016/j.healun.2022.09.007
      Transplant registries in the US do not collect information about community level risk factors. We utilized a community level socio-economic risk indicator, the distressed communities’ index to understand its association with clinical presentation among children listed for heart transplant (HT). We found that currently, majority (40%) of children listed from distressed communities are Black. On multivariable analysis, compared to children from prosperous communities, those from distressed communities listed for HT were significantly more likely to be Status 1A (adjusted odds ratio [aOR] 1.39) and on a ventricular assist device (aOR 1.44). Compared to White children from prosperous communities, both Black and White children from distressed communities were more likely to be listed Status 1A (aOR 2.1 and 1.36 respectively) and have renal dysfunction (aOR 1.71 and 1.52 respectively). In conclusion, heart failure severity at listing appears more likely associated with community-level risk factors and less so with child's race/ethnicity.

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      References

        • Singh TP
        • Almond CS
        • Taylor DO
        • Milliren CE
        • Graham DAJC.
        Racial and ethnic differences in wait-list outcomes in patients listed for heart transplantation in the United States.
        Circulation. 2012; 125: 3022-3030
        • Singh TP
        • Almond CS
        • Gauvreau K.
        Improved survival in pediatric heart transplant recipients: have white, black and Hispanic children benefited equally?.
        Am J Transplant. 2011; 11: 120-128
        • Amdani S
        • Bhimani SA
        • Boyle G
        • et al.
        Racial and ethnic disparities persist in the current era of pediatric heart transplantation.
        J Card Fail. 2021; 27: 957-964
      1. Distressed Communities Index - Economic Innovation Group. Available at: https://eig.org/dci. Accessed: February 14, 2022.

        • Mentias A
        • Desai MY
        • Vaughan-Sarrazin MS
        • et al.
        Community-level economic distress, race, and risk of adverse outcomes after heart failure hospitalization among medicare beneficiaries.
        Circulation. 2022; 145: 110-121
        • Charles EJ
        • Mehaffey JH
        • Hawkins RB
        • et al.
        Socioeconomic distressed communities index predicts risk-adjusted mortality after cardiac surgery.
        Ann Thorac Surg. 2019; 107: 1706-1712
        • Schold JD
        • King KL
        • Husain SA
        • Poggio ED
        • Buccini LD
        • Mohan S.
        COVID-19 mortality among kidney transplant candidates is strongly associated with social determinants of health.
        Am J Transplant. 2021; 21: 2563-2572
        • Bhimani SA
        • Hsich E
        • Boyle G
        • et al.
        Sex disparities in the current era of pediatric heart transplantation in the United States.
        J Heart Lung Transplant. 2022; 41: 391-399
      2. Census regions and divisions of the United States. Available at: https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf. Accessed: January 6, 2022.

        • Breathett K
        • Liu WG
        • Allen LA
        • et al.
        African Americans are less likely to receive care by a cardiologist during an intensive care unit admission for heart failure.
        JACC. 2018; 6: 413-420
        • Breathett K
        • Yee E
        • Pool N
        • et al.
        Does race influence decision making for advanced heart failure therapies?.
        J Am Heart Assoc. 2019; 8e013592
        • Joyce DL
        • Conte JV
        • Russell SD
        • Joyce LD
        • Chang DC.
        Disparities in access to left ventricular assist device therapy.
        J Surg Res. 2009; 152: 111-117
        • Breathett K
        • Yee E
        • Pool N
        • et al.
        Association of gender and race with allocation of advanced heart failure therapies.
        JAMA Netw Open. 2020; 3 (e2011044-e2011044)