Heart transplants don’t last as long in black kids
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Transplanted hearts survive a significantly shorter time in black children than in other racial groups, according to a review of the records of 4227 pediatric heart transplant recipients, 717 (17 percent) of whom were black.
Dr. William T. Mahle and colleagues from Emory University School of Medicine in Atlanta found that the rate of heart transplants surviving for 5 years was 51 percent for black recipients versus 69 percent for other recipients.
A transplanted heart lasted for an average of 5.3 years in black children compared with 11.0 years in children of other racial groups, Mahle’s team reports in the Journal of Pediatrics.
These differences were not explained by differences in socioeconomic or insurance status. “We can’t just chalk it all up to having lower income,” Mahle said in an interview with Reuters Health. “African-Americans on average have lower incomes, but it doesn’t look like that’s the issue.”
He continued: “We are starting to understand that there are biologic differences between racial groups, and that maybe we’ll need to tailor medications or our approach to transplant a bit differently.”
As an example, he pointed to a recent study of adult heart failure patients that suggested some medications are effective in African-Americans but not in other patient populations.
The finding in the current study of poorer heart-transplant survival in black children has at least two immediate implications, Mahle said. “We need to be honest with families when we counsel them about a transplant in a child who is African-American and tell them that they cannot honestly expect the same survival of that heart as a white or Asian child.”
It’s also important for families to weigh transplantation against other options, he said.
Racial differences in the outcome in heart transplantation, Mahle predicted, “will be a big area of research going forward because there is tremendous room for improvement. Somehow we have to get African-American children to have their heart transplants last 10, 12, 15 years,” which is the norm for other populations.
SOURCE: Journal of Pediatrics, December 2005.
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