Racial and Sexual Disparities in Solid Organ Transplant Outcomes Since Implementation of the Affordable Care Act Insurance Expansion Across Some States
1Morsani College of Medicine, University of South Florida, Tampa, FL, 2Honors College, University of South Florida, Tampa, FL, 3Transplant Surgery, Tampa General Hospital, Tampa, FL
Meeting: 2021 American Transplant Congress
Abstract number: 310
Keywords: Medicare, Outcome, Prognosis, Survival
Topic: Clinical Science » Organ Inclusive » Non-Organ Specific: Disparities to Outcome and Access to Healthcare
Session Information
Session Name: Disparities in Access and Machine Learning Outcomes in Solid Organ Transplantation
Session Type: Rapid Fire Oral Abstract
Date: Tuesday, June 8, 2021
Session Time: 4:30pm-5:30pm
Presentation Time: 4:35pm-4:40pm
Location: Virtual
*Purpose: Achieving solid organ transplantation traditionally requires access to health insurance. As such, women and people of color have faced barriers to obtaining solid-organ transplants. The Affordable Care Act (ACA) expanded Medicaid eligibility and thus has decreased health disparities among women and minorities. The goal of this project was to determine any differences in transplant outcomes by sex and race in states that have implemented the ACA expansion of healthcare insurance. We hypothesized that there will be an improvement by sex and race in transplant outcomes in states that have implemented the ACA expansion of healthcare insurance.
*Methods: We conducted a retrospective cohort study of all consecutive patients in the U.S. undergoing heart, kidney, lung, and liver transplants from Jan. 2010 to Dec. 2019. Patient data was obtained from the United Network for Organ Sharing and the Organ Procurement and Transplantation Network. Pediatric patients and multiorgan recipients were excluded. Variables, including demographics, were examined. There were four racial categories recorded (White, Black, Hispanic, and Other). We looked at the number of transplants before and after the ACA expansion for each organ system and reviewed the results based on sex and race.
*Results: There was an increase in the number of transplants for both males and females post-ACA expansion across all organ systems. However, male patients showed a significantly higher increase as compared to female patients with regards to liver transplants (p=0.010). There was an increase in the number of transplants for all races/ethnicities post-ACA expansion across all organ systems (Figure 1). However, the rate of increase was not equal. White patients saw a higher increase in the number of transplants as compared to non-white patients across all organ systems (p<0.001).
*Conclusions: Since the implementation of the ACA, which granted greater access to insurance, sexual and racial disparities have decreased. However, these disparities still exist with solid organ transplantation. Explanations associated with these inequalities are multifaceted and need to be further explored to facilitate the development of solutions that advance the system while improving transplant patient outcomes by race and sex.
To cite this abstract in AMA style:
Mohamed H, Conceicao C, Kumar A, Buggs J. Racial and Sexual Disparities in Solid Organ Transplant Outcomes Since Implementation of the Affordable Care Act Insurance Expansion Across Some States [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/racial-and-sexual-disparities-in-solid-organ-transplant-outcomes-since-implementation-of-the-affordable-care-act-insurance-expansion-across-some-states/. Accessed May 16, 2025.« Back to 2021 American Transplant Congress