Impacts of social inequalities on the survival of heart transplant recipients in a developing country

Background Heart transplant (HT) is an alternative for patients with advanced heart failure (HF). Social inequalities may influence survival, but are still not well understood. The aim of this study was to assess the impact of social and clinical inequalities on the survival of HT recipients. Methods Retrospective cohort study conducted at a Brazilian hospital from 2006 to 2018. Results Three hundred and two patients were analyzed. Most HT recipients were male (205, 67.9%), mixed race 146 (48.3%), retired (166, 56.5%), median age 47 (38-57) years, and had studied no more than eight years (191, 65.8%), were younger than 60 years old (256, 84.7%). 149 (51.7%) had per capita monthly income inferior to one Brazilian minimum wage, equivalent to US$250. 123 (95.4%) out of 129 patients had allograft cellular rejection 2R or 3R. Median donor age was 32 (23-39) years. The overall survival was 76.6%, 62.2%, and 58.2%, at 1, 5, and 10 years, respectively. Age <60 years old and higher income were associated with a greater chance of survival (p-values .009 and <.001, respectively). Conclusion Younger age and higher per capita income had positive impact on HT recipient survival. The level of education did not affect survival in this cohort.