Combined Heart-Lung Transplantation Outcomes in Asian Populations: National Database Analysis.

Background

Heart-lung transplantation (HLTx) is a definitive surgical procedure for end-stage cardiopulmonary failure. Studies to understand the relationship between ethnicity and race and outcomes after HLTx are needed to uphold equitable HLTx access to the increasingly diverse U.S. population facing advanced cardiopulmonary failure.

Objectives

This study sought to examine the outcomes of HLTx recipients of Asian origin, with emphasis on the ethnic and racial disparities in the outcomes.

Methods

We analyzed data from the United Network for Organ Sharing (UNOS) for patients of ≥18 years of age who underwent HLTx between 1987 and 2021. Propensity-score matching was performed between Asian and non-Hispanic Whites (NHWs), with a 1:3 matching ratio based on the propensity score of each patient estimated by multivariable logistic regression.

Results

We identified 42 Asian and Asian American heart-lung transplant recipients and 834 NHW recipients. In the pre-matched cohort, the median survival was 1,459 days (IQR: 1,080-2,692 days) in Asian recipients after transplantation, whereas it was 1,521 days (IQR: 1,262-1,841 days) in White recipients. Of the 876 recipients, 156 transplants were successfully matched (Asian, n = 36; NHW, n = 108). Among the post-transplantation outcomes, there were no significant differences in morbidity and mortality between Asian and NHW cohorts.

Conclusions

This large-scale analysis in Asian patients will have important implications in Asian countries that have relatively fewer HLTx surgeries. An outcome equivalent to NHW in Asian patients, as demonstrated in our study, could be the driving force for further expansion of HLTx surgeries in Asian countries.

Informations de copyright

© 2022 The Authors.

Déclaration de conflit d'intérêts

The Stanford Center for Asian Health Research and Education (CARE) and the CARE Scholars program has provided funding support of this project. The data reported in this study were supplied by the United Network for Organ Sharing as the contractor for the Organ Procurement and Transplantation Network. The United Network for Organ Sharing is a private non-profit organization that manages the nation’s organ transplant system under contract with the federal government. This system serves as a model for transplant systems worldwide. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.