Racial/Ethnic Disparities Seen in Liver Transplantation Rates
Rates in some Hispanic, Asian groups lag behind whites; geographic variation has key role
THURSDAY, Aug. 26 (HealthDay News) -- Subgroups of Hispanics and Asians in the United States have a lower rate of deceased donor liver transplantation (DDLT) than whites, and geographic variation appears to be a main factor accounting for disparities in liver transplantation among racial and ethnic groups, according to research published in the September issue of Liver Transplantation.
Amit K. Mathur, M.D., of the University of Michigan in Ann Arbor, and colleagues analyzed data from the Scientific Registry for Transplant Recipients on 39,114 adult chronic end-stage liver disease patients waitlisted for transplantation during 2002 to 2007. They evaluated the rates of DDLT -- stratified by donation service area (DSA) and Model of End-stage Liver Disease (MELD) score -- for whites, Hispanics, African-Americans, Asians, and others.
Before adjustment for DSA, the researchers found that African-Americans had a 10 percent lower DDLT rate than whites, but after adjustment the deficit in the rate was 2 percent and not significant, suggesting more African-Americans live in areas with organ shortages. Even after adjustment for DSA, compared to whites, Hispanics had an 8 percent lower DDLT rate. After stratification by DSA, Hispanics with a MELD score under 20 had a 15 percent lower rate than whites, but this difference did not exist with higher MELD scores. Overall transplant rates were similar between Asians and whites. However, Asians with MELD scores of six to 14 had a transplant rate that was 24 percent higher than whites, but those with MELD scores above 15 had a transplant rate that was 15 to 46 percent lower than whites.
"Geographic variation is being increasingly recognized as a threat to optimizing the use of donated organs, and, in our study, had a clear effect on the measured differences in transplant rates between minorities and whites," the authors write.