The recent focus on racial inequalities highlights the need to evaluate and address systemic biases (often unrecognized and unintended) affecting minority groups in health care. Specific to pediatric heart transplantation, disparities in outcomes have been documented in national registry studies with lower survival after listing and transplantation in non-White patients. [1][2][3][4] However, registry databases do not extend to the time before waitlisting for transplantation. Therefore, the potential for bias in the pediatric heart transplant candidate referral and evaluation process has been understudied.We retrospectively studied our single-center experience evaluating
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