ArticleCirculation. Heart failure2018
Socioeconomic Disparities in Adherence and Outcomes After Heart Transplant: A UNOS (United Network for Organ Sharing) Registry Analysis.
Article in Circulation. Heart failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed.
- Short-Term Care Burden After Left Ventricular Assist Device Implantation and Heart Transplant in the United States.Journal of the American Heart Association · 2026Article
- Geographic disparity beyond the physical distance: Heart transplant outcomes in patients living in states without a transplant program.JHLT open · 2025Article
- Unequal Hearts: Racial Disparities Persist in Heart Transplant Outcomes.Journal of the American Heart Association · 2025Article
- Racial Disparities in Heart Transplantation: Long-Term Graft Survival and Nonmortality Outcomes.Journal of the American Heart Association · 2025Article
- Child and adolescent heart and lung post-transplant adherence.JHLT open · 2025Article
- The New Horizon: A Viewpoint of Novel Drugs, Biomarkers, Artificial Intelligence, and Self-Management in Improving Kidney Transplant Outcomes.Journal of clinical medicine · 2025Article
- Discrepancies in survival following pediatric heart transplantation and the effect of race and socioeconomic status on outcomes.JTCVS open · 2025Article
- The application of neighborhood area deprivation index to improve health equity across the spectrum of heart failure: a review.Heart failure reviews · 2025Review
- Disparities in heart transplant survival and graft rejection outcomes persist in the modern era: a call to race towards a more equitable future.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Evaluating Challenges in Access To Transplantation for Persons with HIV.Current HIV/AIDS reports · 2025Review
- Race, Genetics, and Social Determinants of Health in Transthyretin Cardiac Amyloidosis: A Literature Review and Call to Action.Current cardiology reports · 2025Review
- Socioeconomic Status and Major Adverse Transplant Events in Pediatric Heart Transplant Recipients.JAMA network open · 2024Article
- Recipient functional status impacts on short and long-term intestinal transplant outcomes in United States adults.World journal of transplantation · 2024Article
- Insurance-based Disparities in Outcomes and Extracorporeal Membrane Oxygenation Utilization for Hospitalized COVID-19 Patients.Anesthesiology · 2024Article
- Impact of institutional variables on centre performance in long-term survival after heart transplant.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- Heart transplantation in patients from socioeconomically distressed communities.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Racial and Ethnic Disparities in Peri-and Post-operative Cardiac Surgery.Current cardiovascular risk reports · 2024Review
- Increased disparities in waitlist and post-heart transplantation outcomes according to socioeconomic status with the new heart transplant allocation system.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Lung transplantation outcomes in patients from socioeconomically distressed communities.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023Article
- Sarcopenia Adversely Affects Outcomes following Cardiac Surgery: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
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Authors and funding
11 authors.
Funding
Abstract
backgroundThere is mixed evidence of racial and socioeconomic disparities in heart transplant outcomes. Their underlying cause-and whether individual- or community-level traits are most influential-remains unclear. The current study aimed to characterize socioeconomic disparities in outcomes and identify time trends and mediators of these disparities. METHODS AND
resultsWe used United Network for Organ Sharing registry data and included 33 893 adult heart transplant recipients between 1994 and 2014. Socioeconomic status (SES) indicators included insurance, education, and neighborhood SES measured using a composite index. Black race and multiple indicators of low SES were associated with the primary outcome of death or retransplant, independent of baseline clinical characteristics. Blacks had lower HLA and race matching, but further adjustment for these and other graft characteristics only slightly attenuated the association with black race (HR, 1.25 after adjustment). This and the associations with neighborhood SES (HR, 1.19 for lowest versus highest decile), Medicare (HR, 1.17), Medicaid (HR, 1.29), and college education (HR, 0.90) remained significant after full adjustment. When comparing early (1994-2000) and late (2001-2014) cohorts, the disparities associated with the middle (second and third) quartiles significantly decreased over time, but those associated with lowest SES quartile and black race persisted. Low neighborhood SES was also associated with higher risks of noncompliance (HR, 1.76), rejection (HR, 1.28), hospitalization (HR, 1.13), and infection (HR, 1.10).
conclusionsRacial and socioeconomic disparities exist in heart transplant outcomes, but the latter may be narrowing over time. These disparities are not explained by differences in clinical or graft characteristics.
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