Heart transplantation is the definitive treatment for end-stage heart failure. Left ventricular assist devices (LVADs) are a continually improving technology that extends life for candidates on the transplant waiting list. We use transplant registry data from the United Network for Organ Sharing (N=5,550) and fundamental cause theory to understand how type and timing of LVAD implantation are associated with differences in heart transplant wait list outcomes among black and white candidates. Consistent with fundamental cause theory, we found that although black and white candidates were equally likely to receive newer continuous flow LVADs, black candidates were more likely to undergo LVAD implantation after transplant listing (i.e., later in the disease course). This later timing of technological intervention contributed to poorer wait list outcomes among black transplant candidates, which included lower likelihood of receiving a heart transplant and greater likelihood of being removed from the wait list due to worsening health.
Presented in Session 52. Flash Session: Gender, Race/Ethnicity, and Health