ArticleJTCVS open2025
Discrepancies in survival following pediatric heart transplantation and the effect of race and socioeconomic status on outcomes.
Article in JTCVS 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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7 authors.
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Abstract
Objectives: Poor health literacy and resources paucity in families with low socioeconomic status can be detrimental in children requiring complex outpatient management such as heart transplantation. We assessed the influence of socioeconomic status and insurance type on heart transplantation outcomes. Methods: The cohort of children undergoing heart transplantation was generated by merging the United Network for Organ Sharing and Pediatric Health Information System databases. Family's annual income was used as surrogate for socioeconomic status. Children were divided into 3 groups: low-income (lower quartile, <$32 700; n = 639), medium-income (second and third quartiles, $32 700-$53 600; n = 1305), or high-income (upper quartile, >$53 600; n = 649). Results: Comparison showed racial discrepancies (more Whites in high-income, more Blacks in low-income groups), and insurance type variations (more private in high-income, more Medicaid in low-income groups). On univariate analysis, survival was higher for high-income compared with medium-income and low-income groups ( Conclusions: Black and low socioeconomic status children face significant disadvantages in heart transplant outcomes, including lower survival, higher rejection rates, and increased risk of death secondary to cardiac arrest. Access to private insurance leads to better survival but might be proxy to better resources, education, and compliance.
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