FRIDAY, Feb. 15 (HealthDay News) -- Blacks awaiting a lung
transplant during a recent 10-year period were less likely to
receive a new lung and more likely to die or be removed from the
transplant list than whites, according to researchers.
The findings, published in the second February issue of the
American Journal of Respiratory and Critical Care Medicine,
also showed that blacks on the transplant list between 1995 and
2004 were more likely to lack private insurance, live in poorer
neighborhoods, and have greater cardiovascular risk factors, such
as diabetes and pulmonary hypertension. However, these factors did
not account for the findings.
These disparities are consistent with those observed among
patients awaiting kidney and liver transplantation and among
patients with other advanced lung diseases such as pulmonary
arterial hypertension and pulmonary fibrosis, lead researcher Dr.
David Lederer, of Columbia University Medical Center, said in a
prepared statement. This finding was independent of age, lung
function, cardiovascular risk factors, transplant center volume,
type of health insurance coverage, and neighborhood poverty
level.
The researchers assessed the 280 non-Hispanic black adults and
5,272 non-Hispanic white adults diagnosed with chronic obstructive
pulmonary disease (COPD) or emphysema who were on the United
Network for Organ Sharing lung transplantation list between 1995
and 2004. The investigators tracked the outcomes (death,
transplantation, removal from the list or still living) of those on
the list and analyzed the results with respect to age, sex, disease
severity, community poverty level and transplant center volume.
While the organ allocation system in place during the study
period has been replaced with one that prioritizes patients based
on the survival benefit of transplantation, Lederer said the
effects of poor insurance and poverty will likely still place
blacks at increased risk for removal from the list or death.
Also, researchers were surprised at the low number of blacks
that even made the list. "Based on what we know about COPD, we
expected that twice as many black patients would have been put on
the lung transplant waiting list. Our findings point to significant
barriers to accessing lung transplantation for minorities," Lederer
said. "These findings should alert primary-care physicians and
pulmonologists to consider referral of black patients with COPD for
transplantation at the earliest signs of advanced disease."
More information
The National Heart, Lung, and Blood has more about
chronic obstructive pulmonary disease.
