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Hispanics and Asians less likely to receive liver transplants
Date:8/19/2010

nority, and fail to account for changes in the severity of liver disease over time while candidates are waitlisted.

The authors conducted a Scientific Registry of Transplant Recipients analysis of data submitted to the Organ Procurement and Transplantation Network (OPTN). They considered 39,114 adult chronic end-stage liver disease candidates on the waitlist between 2002 and 2007. The primary variable of interest was candidate race (74.1% Caucasian, 13.9% Hispanic, 7.3% African-American and 3% Asian) and the primary outcome of interest was transplant rates by race/ethnicity, stratified by DSA and MELD score.

The analysis reveals that without adjustment by DSA, African-Americans appeared to have a 10% lower rate of receipt of LT as compared to Caucasians. After adjustment by DSA the deficit in this rate decreased to 2% and was no longer significant, , suggesting a direct link to DSA as the source of racial disparity and that African Americans are likely over represented in DSAs with organ shortage.

In contrast, Hispanics had an 8% lower LT rate than Caucasians even after adjustment for DSA. Stratified by DSA, this difference was pronounced at a MELD score < 20 (15% lower transplant rate) but the difference was no longer present at higher MELD scores. The persistently lower rates of transplant for Hispanics even after consideration of DSA may indicate Hispanics are over represented at centers that transplant candidates at higher MELD scores. Prior studies also suggest that Hispanics are overrepresented in DSAs with longer median waiting times for LT.

Asians experienced no significant difference in liver transplant rates compared to Caucasians. On analysis of MELD subgroups, however, Asian candidates with lower MELD scores (6-14) had a 24% higher transplant rate relative to Caucasians but a lower transplant rate (15-46%) was observed at MELD scores >15, possibly due to a combination of center effect as well as donor issues su
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Contact: Dawn Peters
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Wiley-Blackwell
Source:Eurekalert

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