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Matching Heart Donors by Race Unnecessary?

Death rates higher among black recipients, but ethnicity of donor made no difference, study shows

TUESDAY, June 1 (HealthDay News) -- A constellation of factors -- including flaws in the health care system, insurance and education levels and biological differences between the races -- may explain why blacks often do worse than whites after undergoing heart transplants, a new study suggests.

The researchers also found that the race of the person who donated the heart doesn't affect whether the person receiving it will fare better or worse after the transplant, according to the report published online June 1 in the Annals of Thoracic Surgery.

"It does not matter whether a white, black, Hispanic or Asian donor heart is transplanted into a patient of any other particular race," senior study investigator and Johns Hopkins transplant surgeon Dr. Ashish Shah said in a news release. "Other factors must be the reason for any differences in how well people do after transplantation, in particular why blacks have poorer outcomes."

Shah and colleagues examined more than 20,000 medical records of patients who received heart transplants in North America between 1997 and 2007. They found that matching donor hearts by race -- transplanting hearts into patients of the same ethnic group as the donor -- made no difference in the life span of recipients.

Thirty-five percent of the black recipients died after five years, regardless of the race of the person who donated the heart. For white and Hispanic recipients, the death rates were 26 and 28 percent, respectively. There weren't enough Asians included in the study to provide valid percentages for this group.

"This problem is not just about biology or race, it is also about the health system that supports our patients," Shah said, noting that patients with public insurance had a higher risk of dying than those with private insurance.

More information

For more on heart transplants, try the U.S. National Library of Medicine.

-- Randy Dotinga

SOURCE: Johns Hopkins Medicine, news release, May 31, 2010

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