Transplantation |

Variation in African-American Lung Transplantation in the Southeastern US FREE TO VIEW

Tabassum Khan, BA; Jennie Perryman; Rachel Patzer, PhD; Remzi Bag, MD; E. Lawrence, MD; Seth Force, MD; David Neujahr, MD
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Emory University School of Medicine, Atlanta, GA

Chest. 2015;148(4_MeetingAbstracts):1086A. doi:10.1378/chest.2243386
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SESSION TITLE: Transplantation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Lung transplantation (LT) is an accepted therapy for many end-stage lung disorders. UNOS Regions 3 and 11, the Southeastern US, have been observed to transplant proportionally more AAs than the rest of the US. The Scientific Registry for Transplant Recipients (SRTR) has not been analyzed to determine whether there is a difference between the number of AAs receiving LTs (AALTs) in these regions and the US as a whole. We aim to examine these regions in order to determine if differences exist.

METHODS: LT data from 2000-2012 for Regions 3 and 11 were obtained from SRTR. We recorded the number of LTs by center as well as the percent of AA transplanted during each year of the study period and collected similar statistics for OPTN Regions 3 and 11 and the US. Only states performing at least 100 LTs during the study period were included. The percentage AA in each state was obtained from 2010 census data. Z-tests were performed for all comparisons.

RESULTS: 7.21% of LTs in the US between 2000-2012 were AALTs. Region 3 contained 4 states that met criteria (A-D), and Region 11 contained 5 (E-I). Region 3 (11.21% AALTs) and Region 11 (9.96% AALTs) both had a significantly higher percentage of AALTs than the overall US (p<0.05). Within Region 3, State A (20.74% AALTs) had a higher proportion of AALTs than both its region and the overall US (p<0.05), and State B (12.31% AALTs) had a higher proportion of AALTs than the overall US. State D (8.4% AALTs) had a smaller proportion of AALTs than the rest of Region 3 (p<0.05). Within Region 11, State E (19.36% AALTs) had a greater proportion of AALTs than both its region and the overall US (p<0.05). States H (5.96% AALTs) and I (3.92% AALTs) had smaller proportions of AALTs than the rest of Region 11 (p<0.05). State I also had a smaller proportion of AALTs than the overall US (p<0.05). The proportion of AALTs was smaller than the proportion of AA in every state, with the exception of state E (p<0.05).

CONCLUSIONS: There are significantly more AALTs in Regions 3 and 11 than in the rest of the country, but there are intra and interstate variations that merit further study.

CLINICAL IMPLICATIONS: Possible explanations for the variation seen in these data include referral patterns and disparities in health care access. Incidence of lung disease in various racial groups and donor demographics should also be examined. This information may help us create tools for LT evaluation and screening in a way that attempts to decrease racial disparities in LT.

DISCLOSURE: The following authors have nothing to disclose: Tabassum Khan, Jennie Perryman, Rachel Patzer, Remzi Bag, E. Lawrence, Seth Force, David Neujahr

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