title: Outcomes after liver transplantation of patients with Indo-Asian ethnicity.
abstract: BACKGROUND
  The impact of ethnicity on outcomes after orthotopic liver transplantation (OLT) is unclear. The British Indo-Asian population has a high incidence of liver disease but its contribution to the national deceased donor pool is small. We evaluated access to and outcomes of OLT in Indo-Asians.
  
  
  METHODS
  We compared 182 Indo-Asians with white patients undergoing OLT. Matching criteria were transplantation year, liver disease, age, sex. Donor and recipient characteristics, postoperative outcomes, including patient and graft survival, OLT era (early, 1987-2001; late, 2002-2011) were compared. Survival was also analyzed by underlying disease-acute liver failure (ALF) and chronic liver failure.
  
  
  RESULTS
  Indo-Asians had higher diabetes incidence. There were no differences in waiting time for transplantation, despite smaller body size and more uncommon blood groups (B, AB) among Indo-Asians. In the early era, patient survival for Indo-Asians with ALF was worse when compared to whites. In the late era, graft and patient survival at 1, 2, and 5 years were similar between groups.
  
  
  CONCLUSIONS
  This study demonstrates that Indo-Asian patients have equal access to OLT and comparable outcomes to whites in the United Kingdom. Survival has improved among Indo-Asian patients; this may be attributable to careful patient selection in case of ALF, though improvement of patient management may have contributed.
authors.affiliation: 1 The Liver Unit, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham B15 2TH United Kingdom.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rocha
authors.forename: M Thamara
authors.initials: MT
authors.lastname: Perera
authors.forename: Keith
authors.initials: K
authors.lastname: Roberts
authors.forename: Glenn
authors.initials: G
authors.lastname: Bonney
authors.forename: Bridget
authors.initials: B
authors.lastname: Gunson
authors.forename: Peter
authors.initials: P
authors.lastname: Nightingale
authors.forename: Simon R
authors.initials: SR
authors.lastname: Bramhall
authors.forename: John
authors.initials: J
authors.lastname: Isaac
authors.forename: Paolo
authors.initials: P
authors.lastname: Muiesan
authors.forename: Darius F
authors.initials: DF
authors.lastname: Mirza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D016009:Chi-Square Distribution; D016208:Databases, Factual; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000601:surgery*; D004739:England / Q000453:epidemiology; D005260:Female; D006085:Graft Survival; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007194:India / Q000208:ethnology; D053208:Kaplan-Meier Estimate; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists; D044465:White People; D055815:Young Adult