LAUSR

Purpose We previously reported improving 30-year trends in short-term heart transplant outcomes using Scientific Registry of Transplant Recipients (SRTR). While racial disparities in transplant outcomes are well-documented, how these improving trends differ by racial subgroups has not been studied. Methods Using SRTR, we identified all adult heart recipients with racial subgroups white or black. Temporal changes in recipients, donors, and providers were described. Outcome of all-cause death 6 months post-transplant was analyzed by race. Multivariable modified Poisson regression estimated yearly risk of mortality compared to 1989 adjusted for population characteristics and tested for race-year interaction. Results Among 58,204 heart recipients, frequency of black recipients increased 8.6%-23.9% from 1989-2017. Known risk factors (e.g. age ≥ 55, IABP) were more frequent in white and increased over 30 years in both groups. More black recipients had initial urgency of Status 1a/b. In black recipients, 9.5% experienced all-cause death within 6 months of transplant compared to 10.2% of white. Adjusting for population characteristics, mortality risk in black recipients was 13% higher relative to white recipients (p Conclusion From 1989 to 2017, an increasing proportion of heart recipients are black, a racial subgroup that continues to be associated with heightened mortality risk within 6 months post-transplant. Nevertheless, 30-year trends in short-term outcomes have been improving irrespective of recipient race.