ArticleJHLT open2025
Racial disparities in lung function by pulmonary function testing among lung transplant candidates and race-specific reference equations.
Article in JHLT open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Non-White patients with interstitial lung disease (ILD) experience racial disparities in lung transplant waitlist mortality. Race-specific equations for spirometry may contribute by underestimating restriction severity in non-White candidates. We analyzed US lung transplant candidates to assess for disparities in forced vital capacity (FVC) at listing, comparing absolute and adjusted values using race-specific and race-neutral equations. We identified 17,457 adults with ILD listed May 4, 2005 to September 31, 2023. At listing, mean absolute FVC was higher for White patients (2.03 ± 0.80 liters) than Black patients (1.61 ± 0.67 liters) and Asian patients (1.49 ± 0.86 liters). Differences were attenuated after applying race-specific equations (White patients 50.0 ± 17.5%, Black patients 47.7 ± 17.9%, Asian patients 46.2 ± 24.2%). Compared with race-neutral equations, race-specific equations had higher odds of classifying FVC as severe (≤40%) requiring listing in White patients (OR 1.37, 95% CI 1.28-1.40) but lower odds in Black patients (OR 0.82, 95% CI 0.74-0.90). Using race-neutral equations might help improve racial disparities for lung transplant candidates with ILD.
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