Heart transplant patients on Medicaid face a higher risk of major complications
Heart transplant patients insured by Medicaid face a significantly higher risk of cardiac allograft vasculopathy (CAV), according to new research published in The Annals of Thoracic Surgery.[1]
The analysis, based on data from more than 37,000 adult heart transplant patients, is also scheduled to be presented during STS 2025, the annual meeting of the Society of Thoracic Surgeons.
“CAV is a leading cause of morbidity and mortality following heart transplant,” first author Sara Sakowitz, MPH, a medical student at the David Geffen School of Medicine at UCLA, said in a prepared statement. “Our work demonstrates that socioeconomic disadvantage influences the risk of CAV in the months and years following this life-saving operation.”
Sakowitz et al. explored data from the Organ Procurement and Transplantation Network, focusing on 37,073 patients who underwent a heart transplant from 2004 to 2022. Thirteen percent of those patients were insured by Medicaid.
The odds of CAV were significantly higher for patients on Medicaid insurance. However, the group noted, this trend didn’t emerge until the ACA was signed into law.
“Although the Affordable Care Act has expanded access to heart transplantation for previously uninsured patients, significant barriers to accessing longitudinal post-transplant treatment, affordable medications, and equitable, high-quality care remain,” Sakowitz explained.
The group also explored patient mortality. The association between Medicaid and one-year mortality “approached statistical significance,” they wrote, but survival rates remained comparable. After five years, however, survival was found to be “inferior” for Medicaid patients when compared to patients on all other types of insurance.
“Building on our work, future multi-center studies should ascertain best follow-up practices and disseminate these strategies across institutions,” the authors wrote.
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.