Robust Outcomes for Hispanic Lung Transplant Recipients in the United States

Abstract

Race, while a social construct, has a strong effect on a person’s health. There is limited data on racial disparities within lung transplantation (LTx), especially for Hispanic recipients. Therefore, the aim of this study was to identify inequalities that may involve this population. We analyzed historical data from the Organ Procurement and Transplantation Network (OPTN) and performed a retrospective review of Hispanic and Caucasian patients who underwent lung transplantation in the United States between May 4, 2005 and October 31, 2019. We compared pre-transplant health status to that of survival outcomes for both Caucasians and Hispanics using Kaplan-Meier survival analyses and Cox proportional hazards modeling to controlling for age, gender, pre-LTx diagnosis, and type of LTx. During this timeframe, 1,934 Hispanics and 22,767 Caucasians underwent lung transplantation. A statistically significant difference was seen between the two groups regarding age (p < 0.0001), body mass index (BMI) (p < 0.0001), type of lung transplant (bilateral versus single, p < 0.0001), and pre-transplant diagnoses (p < 0.0001). In all included pre-LTx health measures, Hispanics were significantly worse (p ≤ 0.0001-0.0410). Interestingly, it was found that Hispanics have better survival rates at 1 year and 3 years (p < 0.0001) with an associated hazards ratio of 0.927[0.868, 0.991] in comparison to Caucasians. Hispanics are underrepresented among LTx recipients, transplanted in worse health, and for diseases that have been noted to have the worst long-term survival outcomes. Despite these factors, Hispanics have a better long-term survival rate post-LTx.