Writing as a rapid communication in the latest issue of the journal, researchers from the Massachusetts General Hospital and the Harvard Medical School, USA, have investigated whether there are disparities among black and white patients in the use of orthotopic liver transplantation.
Orthotopic liver transplantation (OLT) is considered the best treatment for end-stage liver disease, but limited data is available as to the access of ethnic minorities to OLT.
|Time to OLT among recipients did not differ by race|
Andrea E. Reid and colleagues collected data from the United Network for Organ Sharing, on black and white patients between the ages of 18 and 70 who were on OLT waiting lists (n = 29,013).
They also gathered information from the same source on patients who were OLT recipients between 1994 and 1998 (n = 15,805).
Standardized transplant ratios were generated by comparing the racial distribution of OLT patients with the US population and demographic and clinical characteristics of OLT registrants were compared by race.
The researchers then performed multivariate analyses to identify predictors of time to OLT, as well as the likelihood of dying or receiving OLT within 4 years, while controlling for severity of illness and other factors.
Following this, the standardized transplant ration for black OLT recipients (0.65) was found to be significantly lower than the same ration for white OLT recipients (1.05).
Black patients were also younger and sicker than white patients.
However, after adjustment for severity and other factors, time to OLT among recipients did not differ by race.
Despite this, black patients were more likely to die or become too ill for OLT while waiting, and were less likely to receive OLT within 4 years.
Commenting on the results of the study, Dr Reid and her colleagues said, " Adult blacks were under-represented among OLT patients. Although waiting times were similar once listed, black race affected outcomes while awaiting OLT."
They concluded, "The process of referral and evaluation for OLT should be investigated further."