摘要：Objective: To examine the relationship of black.r.ce to graft survival after heart transplantation in children. Study design: United Network for Organ Sharing records of heart transplantation for subjects < 18 years of age from 1987 to 2004 were reviewed. Analysis was performed using proportional hazards regression controlling for other potential risk factors. results: Of the 4227 pediatric heart transplant recipients, 717 (17%)-were black. The 1-year graft survival rate did not differ among groups; however, the 5-year graft survival rate was significantly lower for black.r.cipients, 51%versus 69%, P < .001. The median graft survival for black.r.cipients was 5.3 years as compared with 11.0 years for other recipients. Black.r.cipients had a greater number of human leukocyte antigen mismatches, lower median household income, and a greater percentage with Medicaid as primary insurance, P < .001, P < .001, and P < .001. After adjusting for economic disparities, black.r.ce remained significantly associated with graft failure, odds ratio = 1.67 (95%CI 1.47 to 1.87), P < .001. Conclusions: Median graft survival after pediatric heart transplantation for black.r.cipients is less than half that of other racial groups. These differences do not appear to be related primarily to economic disparities.