Lung transplant wait seen favoring whites
NEW YORK (Reuters Health) - Blacks with chronic lung disease on the waiting list for lung transplantation before 2005 were more likely to die or be removed from the list than were white patients, according to New York investigators.
The researchers suggest that new guidelines, aimed at prioritizing lung transplant candidates based on the expected survival benefit of transplantation, may help reverse this trend.
Dr. David J. Lederer and colleagues at Columbia University College of Physicians and Surgeons compared outcomes for all non-Hispanic black and white patients 40 years or older with chronic obstructive pulmonary disease (COPD) placed on the United Network for Organ Sharing (UNOS) list between 1995 and 2004.
During the study period, organs were allocated based on waiting time. Since 2005, candidate recipients receive priority based on their risk of dying before and after transplantation.
The study included 280 black patients and 5,272 white patients.
Over a five-year period, 62 percent of blacks and 68 percent of whites received a transplant, the team reports in the American Journal of Respiratory and Critical Care Medicine.
While on the waiting list, 17 percent of blacks and 15 percent of whites died. More blacks than whites were also removed from the waiting list, at 14 percent and 9 percent, respectively.
Lederer's group points out that a similar study will be needed after sufficient experience under the new allocation system, to see if it results in more equitable outcomes for black patients awaiting lung transplantation.
SOURCE: American Journal of Respiratory and Critical Care Medicine, February 15, 2008.