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Racial and Ethnic Differences in Liver Transplantation and Post-Liver Transplant Survival Among Patients With
Udhayvir S Grewal1, Apoorva K Chandar2, Shiva J Gaddam3
1University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Insights
Racial and ethnic disparities in liver transplant (LT) for hepatocellular carcinoma (HCC) showed no significant 5-year survival differences between African American, Hispanic/Asian, and Caucasian patients. Equitable access policies may help bridge outcome gaps.
Area of Science:
- Hepatology and Transplant Surgery
- Health Services Research
- Oncology
Background:
- Racial and ethnic disparities in hepatocellular carcinoma (HCC) diagnosis and outcomes are well-documented.
- This study presents updated real-world data on racial or ethnic differences in liver transplantation (LT) and post-LT survival for HCC patients.
Purpose of the Study:
- To analyze racial and ethnic variations in liver transplantation (LT) and post-LT survival among patients with hepatocellular carcinoma (HCC).
- To provide updated, real-world data on disparities in HCC outcomes following LT.
Main Methods:
- Retrospective analysis of the TriNetX database (2012-2022).
- Identification of patients with HCC (ICD-10 C22.0, C22.8) who underwent LT (CPT codes 47,135, 47,140, 47,141, 47,142).
- Comparison of outcomes across racial and ethnic subgroups.
Main Results:
- The study population comprised predominantly Caucasian patients (84.8%), followed by African Americans (9.2%) and Hispanic/Asian patients (7.9%).
- At 5-year follow-up, no significant mortality difference was observed between African American and Caucasian patients (HR=1.087, p=0.59).
- Similarly, no significant mortality difference was found between Hispanic/Asian and Caucasian patients (HR=1.14, p=0.10).
Conclusions:
- Current data suggest no significant 5-year mortality disparity between racial/ethnic groups post-liver transplantation for HCC.
- Stringent implementation of equitable access policies for LT is crucial for bridging overall outcome disparities in HCC.
Background:
Racial and ethnic disparities in diagnosis and overall outcomes for HCC are well known. We present updated real-world data on racial or ethnic differences in LT and post-LT survival among patients with HCC in a large population-based database.
Methods:
We used the TriNetX database to retrospectively identify patients who had HCC (ICD-10 C22.0, C22.8) and underwent LT (CPT codes 47,135, 47,140, 47,140, 47,141, 47,142) from 2012 to 2022 and compared outcomes across racial and ethnic subgroups.
Results:
Majority of the patients were Caucasians (2403/2901, 84.8%), followed by African Americans (267/2901, 9.2%) Hispanic/Asian (231/2901, 7.9%). At follow up of 5 years, we noted no significant difference in mortality between AA and Caucasian patients [HR = 1.087 (95% CI 0.76, 1.56, p = 0.59)] as well as Hispanic/Asian and Caucasian patients [HR = 1.14 (95% CI 0.73, 1.78, p = 0.10)].
Conclusions:
These results indicate that stringent implementation of policies aimed at ensuring equitable access to LT may contribute to bridging disparities in overall outcomes in HCC.
