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Disparities in liver transplantation: the association between donor quality and recipient race/ethnicity and sex.
- Source :
-
Transplantation [Transplantation] 2014 Apr 27; Vol. 97 (8), pp. 862-9. - Publication Year :
- 2014
-
Abstract
- Background: We aimed to examine the association between recipient race/ethnicity and sex, donor liver quality, and liver transplant graft survival.<br />Methods: Adult non-status 1 liver recipients transplanted between March 1, 2002, and December 31, 2008, were identified using Scientific Registry of Transplant Recipients data. The factors of interest were recipient race/ethnicity and sex. Donor risk index (DRI) was used as a donor quality measure. Logistic regression was used to assess the association between race/ethnicity and sex in relation to the transplantation of low-quality (high DRI) or high-quality (low DRI) livers. Cox regression was used to assess the association between race/ethnicity and sex and liver graft failure risk, accounting for DRI.<br />Results: Hispanics were 21% more likely to receive low-quality grafts compared to whites (odds ratio [OR]=1.21, P=0.002). Women had greater odds of receiving a low-quality graft compared to men (OR=1.24, P<0.0001). Despite adjustment for donor quality, African American recipients still had higher graft failure rates compared to whites (hazard ratio [HR]=1.28, P<0.001). Hispanics (HR=0.89, P=0.023) had significantly lower graft failure rates compared to whites despite higher odds of receiving a higher DRI graft. Using an interaction model of DRI and race/ethnicity, we found that the impact of DRI on graft failure rates was significantly reduced for African Americans compared to whites (P=0.02).<br />Conclusions: This study shows that while liver graft quality differed significantly by recipient race/ethnicity and sex, donor selection practices do not seem to be the dominant factor responsible for worse liver transplant outcomes for minority recipients.
- Subjects :
- Adult
Black or African American statistics & numerical data
Asian statistics & numerical data
Cadaver
Female
Hispanic or Latino statistics & numerical data
Humans
Logistic Models
Male
Middle Aged
Proportional Hazards Models
Risk Factors
Sex Distribution
Tissue and Organ Procurement statistics & numerical data
United States epidemiology
White People statistics & numerical data
Ethnicity statistics & numerical data
Graft Survival
Healthcare Disparities ethnology
Healthcare Disparities statistics & numerical data
Liver Transplantation statistics & numerical data
Tissue Donors statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 97
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 24345895
- Full Text :
- https://doi.org/10.1097/01.tp.0000438634.44461.67