尽管进展, Black patients still less likely to get heart transplants
托尔·克里斯滕森，美国心脏协会线上电子游戏飞禽走兽
Black people in need of a new heart are less likely than their white peers to get a transplant, 当他们这么做的时候, 他们之后更有可能死亡, 根据一项新的研究.
这项研究周三发表在《线上娱乐电子游戏网站》杂志上 美国心脏协会杂志, analyzed the impact of changes made in 2018 to how transplants are allocated with the aim of expanding availability.
That year, 器官共享联合网络(UNOS)修订了其分配制度, striving to improve access to organs among the sickest patients and to reduce racial and regional disparities. 旧的制度给不同国家的人们带来了更长的等待线上电子游戏飞禽走兽, 高人口的城市, 可能对黑人和西班牙裔受助人产生不成比例的影响.
Evidence for this situation was reported in 2018 at the 美国心脏协会's Scientific Sessions conference. The 初步研究 在2005年到2016年之间, Black patients experienced longer wait times for a heart transplant than other racial and ethnic groups.
对于这项新研究, 研究人员分析了32名心脏接受者的特征和结果,从2011年到2020年，共有353人参与了这项研究. 他们发现，自2018年新的移植分配制度启动以来, Black, Hispanic and white patients overall spent less time on waiting lists and had better chances of receiving a heart.
但一些种族差异依然存在.
与白人相比, Black patients continued to have a 10% lower likelihood of transplantation. Researchers also found Black patients had a 14% higher risk of post-transplant death during the 10-year period, 与白人患者相比.
“我们可能正在朝着更加公平的方向前进, 但同时, we still have more work to do to reach the goal of offering heart transplant in an equitable fashion to all patients who need it,该研究的合著者Dr. Sounok森.
因为这项研究是观察性的, 要找出造成种族差异的确切原因是不可能的, said Sen, a cardiologist and assistant professor at Yale School of Medicine in New Haven, 康涅狄格. The study also raises the issue of racial bias among medical professionals, Sen said.
“我们知道世界各地都存在这种情况. Whether it's affecting transplant as well is a question we need to ask ourselves very carefully," he said. "We need to look more closely at each of our programs both individually and also on a regional level."
Sen said he's hopeful emerging technologies will expand access and improve transplant success rates for everyone. 他指出了“器官护理系统”, 通常被描述为“盒子里的心”,' that could extend the viability timeframe of the donor heart and allow us to travel farther to obtain suitable organs."
He said another promising option is a "donation after circulatory death" transplant, 或DCD移植. That's when a registered donor is not officially brain-dead but has a devastating, non-survivable neurologic injury and is withdrawn from life support with the family's approval. DCD transplantation is expected to substantially increase the donor pool moving forward.
Dr. Errol Bush, 谁没有参与这项研究, said it was the first study to evaluate changes in racial disparities since UNOS revised the allocation system. He said the results show "systemic racism" still exists when it comes to heart transplants.
“通过强调这些医疗保健差距, 临床医生和政策制定者可以进行对话, 支持调查, 并制定和实施减少它们的解决方案,布什说, an associate professor of surgery and surgical director of the Advanced Lung Disease and Lung Transplantation program at Johns Hopkins University in Baltimore.
He said the new research underscores the need for achieving equity in the world of heart transplants.
Communities that historically have been affected by systemic racism "may require more resources to navigate the complex health care system … while engaging one another to provide more vigilant care,布什说.
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