Twenty-year experience with heart transplant surgery of 820 Asian Americans in the U. S. is described. Pertinent comparisons are made between different ethnic groups and the general population.

There were 447,524 solid organ transplant surgeries in the United States from 1988 to 2008. Of these, there were 265,878 kidneys (59%), 93,937 livers (21%), 45,117 Hearts (10.1%) and the remainders were lungs (4%), pancreas (1.3%), pancreas and kidney (3.5%), heart and lung
(0.22%) and intestines (0.4%).

Overview of Organ Transplantation

There were 45,117 heart transplant surgeries in the United States from 1988 to 2008, of which 43,684 (96.8%) were primary and 1,433 (3.2%) were repeat transplants. Asian Americans amounted to 820 (1.8%) of total heart transplants (788 primary and 32 repeat transplants).

Organ transplantation in the United States is performed according to guidelines and procedures developed by the United Network for Organ sharing (UNOS) and Organ Transplantation and Procurement Network (OPTN). UNOS and OPTN are agencies fully funded by the United States government. These were founded in 1984 and started work in 1988. Data from the UNOS / OPTN experience are presented here.

Methods

Data from OPTN database were analyzed. In situations where data from one site was part of more than one region or state, OPTN guidelines were used to assign data to a particular geographic region.

Demographics of Heart Transplantation Among Asian Americans

Asian Americans started from a low of 7 heart transplants in 1988 and increased to 66 in 2008. Of these males were 596/569 (73%) and females were 224/219. The female Asian American percentage was 27%. In contrast, females were 24.8% of all heart transplants in the general population.

Age and Gender of Recipients

Most recipients – 73% were adults (84.6% in general population, adults = 18 to 64 years age). Children (less than 18 years age) comprised 21% (7.7%in the general population) and elders (more and 65 years) were 6% of the total (compared to 7.8% in the general population). Asian American female recipient percentage was highest for the pediatric (43%) group, followed by adults ( 21%) and least in elder group (18%).

There were 596 males and 224 female Asian Americans who underwent heart transplantation. Female recipients were 43% of total in the pediatric (less than 18 years age) group, 21% of adults (18 to 65 years age) and 17% of elders (more than 65 years age).

ABO Blood Groups

Among 45,117 heart transplant recipients, 17,367 (38.5%) were O, 19,599 (43.4%) were A, 5,887 (13%) were B and 2,264 (5%) were AB. Among 820 Asian Americans there were 271 O group (33%), 255 A group (31%), 222 B group (27%) and 72 AB group (9%).

Increase in Organ Transplant Rates

Asian Americans increased in transplant rate from 7 hearts in 1988 to 66 in 2008, an increase of 942%. This increase in number of Asian Americans receiving heart transplants over a period of twenty years was higher than other ethnic groups, rest of heart transplant population and it was also higher than other organ rate increases. In comparison, in 1988 there were 12,623 total transplants which increased to 25,630 organs in 1988 (49.25%
increase). Kidney transplants increased from 8,878 in 1988 to 15,092 in 2008 (increase of 170%) liver transplants from 1,713 to 5,793 (338% increase), Pancreas from 78 to 405 (519% increase), Kidney and pancreas from 171 to 779 (456% increase), Heart from 1,676 to 2,002 (19.5% increase) and lungs from 33 to 1,362 (4100% increase).

References

1. Dr. Munsif Handbook of Diabetes, 2009. Morristown Publishing Company, P.O. Box 672, Livingston, New Jersey 07039, U.S.A.
2. Dr. Munsif Handbook of Transplant Statistics, 2009, Morristown Publishing Company, P.O. Box 672, Livingston, New Jersey 07039, U.S.A.
3. OPTN data as of February 27, 2009, OPTN, 700 North 4th Street, Richmond, VA 23219.

Conclusion

Heart transplantation among Asian Americans has increased dramatically. This increase is proportionally greater than the increase reported in other ethnic groups and other organs. The proportion of female recipients is higher among young Asian Americans.

Author Bio: Dr. A. N. Munsif is a physician. He publishes on diabetes, heart disease, care of Asian Americans, etc. He publishes on heart disease and various diseases. His publications can be found at spartabook.com and spartabk.com. Copyright (c) 2010 A. N. Munsif

Category: Advice
Keywords: Organ transplantation, Asian American Heart transplant, Heart Failure