Interaction Between Donor and Recipient Race/Ethnicity in Living Donor Liver Transplantation

Document Type

Conference Proceeding

Publication Date


Publication Title

Am J Transplant


Purpose: Living donor liver transplantation (LDLT) is a viable option to increase access to liver transplantation (LT). However, there are well-documented racial and gender-based inequities in access to deceased donor LT. Very little is empirically known about living liver donor (LLD) characteristics in relation to their recipients. Therefore, we aimed to explore the odds of receiving LDLT across LLD and recipient characteristics.

Methods: We explored gender, interactions between LLD-recipient race/ethnicity, and other relevant factors on LDLT utilizing national data from the United Network for Organ Sharing (UNOS) for all adult LLD and their recipients who underwent LDLT from 1/1/2012 through 10/1/2022.

Results: 3469 LDLTs occurred (5.46% of all LTs). A majority of LLDs were female (n 1864, 54%), mean 37.16 years of age (SD 10.41), and White race (n 2791, 81%), followed by Hispanic (n 423, 12%), Black (n 116, 3%), Asian (n 85, 2%), and Other (n 47, 1%). LDLT recipients were predominantly male (n 1843, 53%), mean 53.35 years of age (SD 13.22), and White race (n 2787, 80%), followed by Hispanic (n 437, 13%), Black (n 118, 3%), Asian (n 92, 3%), and Other (n 35, 1%). Of note, 42.9% (n 1487) of LLDs were not biologically related to their recipient. As reported in Table 1, men are both less likely to receive or be a LLD than women. Examining the donor by recipient race interactions, LDLT is more likely to occur between LLD and recipients with the same racial/ethnic category than differing race/ethnicity (regardless of comparator). When race/ethnicity is different between LLD-recipient, four significant interactions occurred indicating that White LLDs are less likely to donate to Black recipients than Hispanic or Others/Unknown and Asian donors are more likely to donate to Others/Unknown than either Hispanic or White recipients.

Conclusions: While biological relatives are assumed to be the same race/ethnicity, nearly half of LLDs are not biologically related to their recipient and yet all racial groups were more likely to donate within their own racial category, adjusting for liver disease category and functional status. Also, despite representing the majority of waitlisted and transplanted patients, men were less likely to receive LDLT, but men are also less likely to be a LLD. These results provide a starting point to foster efforts towards diversifying the LLD population.

PubMed ID

Not assigned.




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