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Race/Ethnicity-Specific Outcomes Among Chronic Hepatitis C Virus Patients Listed for Liver Transplantation

Joseph Ahn1, Benny Liu2, Taft Bhuket2

  • 1Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA.

Digestive Diseases and Sciences
|February 8, 2017
PubMed

Insights

Racial disparities in liver transplantation (LT) for chronic hepatitis C virus (HCV) infection persist. Hispanic HCV patients had better waitlist survival but were less likely to receive LT compared to non-Hispanic whites.

Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Health Disparities Research

Background:

  • Chronic hepatitis C virus (HCV) infection is a primary driver of hepatocellular carcinoma (HCC) and the need for liver transplantation (LT).
  • Existing data do not clearly define if outcomes following LT for HCV differ across racial and ethnic groups.

Purpose of the Study:

  • To investigate ethnic disparities in liver transplantation (LT) outcomes among patients with chronic hepatitis C virus (HCV) in the United States.
  • To evaluate race/ethnicity-specific differences in waitlist survival and the likelihood of receiving LT.

Main Methods:

  • Analysis of data from the United Network for Organ Sharing (UNOS) LT registry between 2003 and 2013.
  • Evaluation of race/ethnicity-specific disparities in LT waitlist survival and LT probability among patients with chronic HCV listed for LT.

Main Results:

  • Among 43,478 HCV patients listed for LT, Hispanic patients exhibited significantly lower waitlist mortality compared to non-Hispanic whites (OR 0.83; p < 0.01).
  • Hispanic HCV patients were significantly less likely to receive LT compared to non-Hispanic whites (OR 0.58; p < 0.001).
  • No significant differences in waitlist mortality or LT probability were observed among black or Asian HCV patients compared to non-Hispanic whites.

Conclusions:

  • The MELD score has mitigated some race/ethnicity-based disparities in waitlist mortality for chronic HCV patients undergoing LT in the USA.
  • Hispanic HCV patients demonstrated superior waitlist survival but a reduced probability of receiving LT, potentially due to slower disease progression than non-Hispanic whites.
Abstract

Keywords:
Hepatocellular carcinomaModel for end-stage liver diseaseRacial disparitiesUNOS/OPTNWaitlist survival

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