Disparities in heart transplantation

Abstract

Purpose of reviewHeart transplantation remains the gold standard therapy for end stage heart failure, but barriers remain, preventing equitable access to and affecting outcomes following transplantation. The objective of this review is to summarize current and historical literature on the disparities that persist, and to highlight the gaps in evidence for further investigation.Recent findingsAlthough progress has been made to increase the rates of advanced heart failure therapies to racial/ethnic minority populations and those with lower socioeconomic status, differential access and outcomes remain. The disparities that persist are categorized by patient demographics, social influences, geopolitical factors, and provider bias.SummaryDisparities in heart transplantation exist, which span a wide spectrum. Healthcare professionals need to be cognizant of these disparities that patients face in terms of access to and outcomes for heart transplantation. Further research and system changes are needed to make heart transplantation a fairer option for patients of varying backgrounds with end stage heart failure.

Why are partial heart transplants important?

“…3 Uptake of partial heart transplantation has the potential to address another serious and persistent ethical problem: there are racial and ethnic disparities in outcomes of both congenital heart surgery 4 and heart transplantation. 5 A procedure that is straightforward and reproducible has the potential to improve results for everyone but particularly for the underserved. This may be particularly of benefit in countries where complex neonatal surgery is less well developed; in many of these countries, homografts are not even available.…”