Liver transplantation in New Orleans: parity in a world of disparity?

Alison A. Smith; Michael Darden; Zaid Al-Qurayshi; Anil S. Paramesh; Mary Killackey; Emad Kandil; Geoffrey Parker; Luis Balart; Paul Friedlander; Joseph F. Buell

doi:10.1016/j.hpb.2017.04.004

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Liver transplantation in New Orleans: parity in a world of disparity?

Journal article

Open access

Peer reviewed

Liver transplantation in New Orleans: parity in a world of disparity?

Alison A. Smith, Michael Darden, Zaid Al-Qurayshi, Anil S. Paramesh, Mary Killackey, Emad Kandil, Geoffrey Parker, Luis Balart, Paul Friedlander and Joseph F. Buell

HPB (Oxford, England), Vol.19(9), pp.793-798

09/01/2017

DOI: 10.1016/j.hpb.2017.04.004

PMID: 28647164

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Abstract

Background: Racial disparity in access to liver transplantation among African Americans (AA) compared to Caucasians (CA) has been well described. The aim of this investigation was to examine the presentation of AA liver transplant recipients in a socioeconomically challenged region. Methods: 680 adult liver transplant candidates and 233 resultant recipients between 2007 and 2015 were analyzed using univariate and multivariate analyses to evaluate factors significant for transplantation. Results: Percentages of wait list patients transplanted were similar between CA and AA (34.9% vs. 32.2%, p = 0.5205). AA were younger (50.4 +/- 1.8 vs. 56.3 +/- 0.7 yrs, p = 0.0003) with higher average MELD scores (22.9 +/- 1.6 vs. 19.4 +/- 0.7, p = 0.0230). Overall patient mortality was similar (AA 22.7% vs. CA 26.3%, p = 0.5931). A multiple linear regression showed that male gender was strongly associated with transplantation. Conclusions: Equal access to liver transplantation remains challenging for racial minorities. At our institution, AA were accepted and transplanted at an equivalent rate as CA despite a higher AA population, HCV rate and diagnosed HCC. AA were younger and sicker at the time of transplant, but overall had similar outcomes compared to CA. Our study highlights the need for studies to delineate the underpinnings of disparity in transplantation access.

Gastroenterology & Hepatology

Life Sciences & Biomedicine

Science & Technology

Surgery

Details

Title: Subtitle: Liver transplantation in New Orleans: parity in a world of disparity?
Creators: Alison A. Smith - Louisiana State University
Michael Darden - Tulane University
Zaid Al-Qurayshi - Louisiana State University
Anil S. Paramesh - Tulane University
Mary Killackey - Tulane University
Emad Kandil - Tulane University
Geoffrey Parker - Dartmouth College
Luis Balart - Tulane University
Paul Friedlander - Tulane University
Joseph F. Buell - Louisiana State University
Resource Type: Journal article
Publication Details: HPB (Oxford, England), Vol.19(9), pp.793-798
DOI: 10.1016/j.hpb.2017.04.004
PMID: 28647164
NLM abbreviation: HPB (Oxford)
ISSN: 1365-182X
eISSN: 1477-2574
Publisher: Elsevier
Number of pages: 6
Language: English
Date published: 09/01/2017
Academic Unit: Otolaryngology
Record Identifier: 9984702947102771

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