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News

Racial disparities in utilization of liver transplantation in the USA

This month's issue of The American Journal of Gastroenterology finds racial disparities in utilization of liver transplantation for hepatocellular carcinoma in the United States.

News image

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The extent of use of liver transplantation on a population scale to treat hepatocellular carcinoma in the United States is unknown.

Dr Abby Siegel and colleagues from New York, USA assessed recent predictors of use of liver transplantation, and its effect on survival for those with nonmetastatic hepatocellular carcinoma.

African Americans were about half as likely to receive a transplant
The American Journal of Gastroenterology

The team identified adults registered in Surveillance, Epidemiology, and End Results with hepatocellular carcinoma between 1998 and 2002.

The team examined determinants for receipt of a liver transplant in univariate and multivariable analyses.

Kaplan-Meier survival curves were constructed for those who received and did not receive a transplant for hepatocellular carcinoma.

The researcher identified 1,156 adults with small (5 cm or less) nonmetastatic hepatocellular carcinoma.

The researchers found that approximately 45% were white, 29% Asian, 17% Hispanic, and 9% African American.

Only 21% received a transplant.

More recent year of diagnosis, younger age, being married, white race, and smaller tumor size each predicted receipt of transplant.

The team found African Americans and Asians were about half as likely to receive a transplant as compared with white patients.

The researchers observed a similar trend in Hispanics, but this was not statistically significant.

Those who underwent liver transplantation for localized hepatocellular carcinoma had 3- and 5-year survivals of 81% and 75%, respectively.

Dr Siegel's team concluded, "Only a fifth of those with small, nonmetastatic hepatocellular carcinoma received liver transplantation."

"Transplanted patients have long-term survival similar to that of the best single-institution studies."

"However, marked racial variations were seen, with African Americans and Asians significantly less likely to receive a transplant after controlling for other variables."

Am J Gastroenterol 2008: 103(1): 120-7
15 January 2008

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