Disparities in liver transplant outcomes in black versus other patients

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Conference Proceeding

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Background: The purpose of this study is to explore disparities in liver transplants in Black patients. The outcomes of interest were the effect of race and sex on evaluation time, likelihood of being waitlisted and transplanted, and post-transplant death. Methods: We identified patients who were evaluated for a liver transplant at a single transplant center from 2015-2020. From the transplant database, we gathered data on patient demographics, length of time of their evaluation, whether they were placed on the transplant waitlist, whether they received a transplant, and death from transplant date. Results: A total of 1838 patients were included in the study. Of these, 713 (39%) were placed on the transplant waiting list and, among them, 226 (32%) received a liver transplant. Among the total, 225 patients were Black, while 1082 patients were male and 756 patients were female. The average age of patients in the study was 56 (ranging from 21-80). Among Black patients who were evaluated, 31% were placed on the transplant waitlist, while 66% of non-Black patients were put on the waitlist (p<0.001). Specifically looking at Black and Caucasian patients, the former group had an average evaluation period of 231 days compared to 168 days for the latter group (p=0.001). Of the patients who were placed on the waitlist, 36% of Blacks and 45% of non-Blacks received a liver transplant (p<0.001). Post-transplant death was 28% for Black and 11% for Caucasian patients (p=0.016). Of male patients who were evaluated for liver transplant, 41% were placed on the waitlist, while 36% of females were put on the waitlist (p=0.061). Among these patients, 32% of males and 31% of females received a transplant (p=0.637). Death post-transplant was 13% for males and 12% for females (p=0.749). The average age of those who experienced posttransplant mortality was 58.2 ± 11.9. Conclusion: Race had a significant effect on liver transplant outcomes, while sex did not play a significant role. Black patients were evaluated for a liver transplant for a significantly longer period of time, but were still less likely to be placed on the waitlist or receive a transplant compared to other races. Post-transplant death was also significantly higher in Black patients.

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