Racial differences in liver transplantation outcomes in the MELD era.
OBJECTIVE
Beginning February 28, 2002, the Model for End-Stage Liver Disease (MELD) score was introduced to better allocate donor livers. Racial differences in orthotopic liver transplantation (OLT) outcomes prior to this time have been attributed to late listing of some racial groups. Racial differences in post-transplant survival in the MELD era have not been previously examined.


METHODS
We performed a retrospective observational cohort study using the United Network for Organ Sharing database for adult liver transplants performed between 2002 and 2006. We examined patient and graft survival at 2 yr and compared disease-specific survival rates among the different races.


RESULTS
A total of 10,409 whites, 1,133 blacks, 1,548 Hispanics, and 765 transplant recipients belonging to other races were included in the study. On multivariate analysis, blacks had lower overall (hazard ratio for death [HR] 1.29, 95% confidence interval [95% CI] 1.10-1.52) and graft (HR 1.38, 95% CI 1.20-1.58) survival at 2 yr compared to whites, while Hispanics had better overall (HR 0.78) and graft (HR 0.82) survival. Compared to whites, blacks transplanted for hepatitis C or HCC had lower survival at 2 yr.


CONCLUSIONS
In the MELD era, black patients have significantly lower overall and graft survival at 2 yr compared to whites.
Ananthakrishnan
Ashwin N
AN
Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
Saeian
Kia
K
D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D016031:Liver Transplantation / Q000208:ethnology* / Q000401:mortality; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D044465:White People / Q000706:statistics & numerical data*