Children from socioeconomically disadvantaged communities present in more advanced heart failure at the time of transplant listing

Transplant registries in the US do not collect information about community level risk factors. We uti-lized a community level socio-economic risk indicator, the distressed communities' index to under-stand its association with clinical presentation among children listed for heart transplant (HT). We found that currently, majority (40%) of children listed from distressed communities are Black. On mul-tivariable analysis, compared to children from prosperous communities, those from distressed commu-nities listed for HT were significantly more likely to be Status 1A (adjusted odds ratio [aOR] 1.39) and on a ventricular assist device (aOR 1.44). Compared to White children from prosperous communities, both Black and White children from distressed communities were more likely to be listed Status 1A (aOR 2.1 and 1.36 respectively) and have renal dysfunction (aOR 1.71 and 1.52 respectively). In con-clusion, heart failure severity at listing appears more likely associated with community-level risk fac-tors and less so with child's race/ethnicity. J Heart Lung Transplant 2023;42:150-155 (c) 2022 International Society for Heart and Lung Transplantation. All rights reserved.

Automated summary

Transplant registries in the US lack community level risk factor information. This study used a community level socio-economic risk indicator called the distressed communities' index to examine its association with clinical presentation among children listed for heart transplant. The findings showed that a large proportion of children listed from distressed communities were Black. Children listed from distressed communities were more likely to have higher heart transplant priority and use a ventricular assist device compared to those from prosperous communities. The severity of heart failure at listing was found to be more associated with community-level risk factors rather than the child's race/ethnicity.