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Published on: September 30, 2021
Racial and Ethnic Disparities in Outcomes in Liver Transplantation for Hepatocellular Carcinoma
Devika Dixit1, Curtis Warren2, Sergio Duarte2
1Department of Medicine, University of Florida, Gainesville, Florida.
Introduction:
Racial and ethnic disparities in liver transplantation (LT) for hepatocellular carcinoma are understudied.
Methods:
Patient and tumor characteristics of all LT in the United States from April 2012 to June 2021 were obtained from a nationwide database (UNOS STAR files). Separate analyses were conducted for transplant and waitlist outcomes. Statistical tests were conducted to look for differences among racial/ethnic groups and assess survival outcomes.
Results:
Asian patients had the highest graft and patient transplant and waitlist survival rates. Non-Hispanic Black (NHB) recipients had the lowest graft and patient survival rates after transplant at 6 mo, 1 y, and 3 y. Hispanic patients had the lowest waitlist survival. Hispanic patients had the highest Model for End-Stage Liver Disease at listing and the highest proportion of diabetes diagnosis, while NHB had the lowest proportion of private insurance.
Conclusions:
NHB patients had poorest posttransplant survival rates and Hispanic patients had worst waitlist survival for LT in hepatocellular carcinoma possibly due to an interplay of socioeconomic and metabolic factors. Addressing these disparities necessitates a comprehensive approach, including areas like healthcare access improvements, lifestyle interventions, and policy development.
