title: Characterization of Hepatitis B and C Among Liver Transplant Recipients With Hepatocellular Carcinoma: An Analysis of the Nationwide Inpatient Sample Database.
abstract: BACKGROUND
  Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for most hepatocellular carcinoma (HCC) and subsequent liver transplant cases. Racial/ethnic disparities exist in access to liver transplantation and post-transplantation survival, and we sought to compare and explore potential disparities in HBV and HCV-related liver transplant populations.
  
  
  METHODS
  The Nationwide Inpatient Sample database was used (2001 to 2010).
  
  
  RESULTS
  In this study, 2269 liver transplant recipients were included: 56% HCV, 6% HBV, and 37% non-HV. HBV and HCV patients were mostly Asian/Pacific Islander (API) and white, respectively. Within HBV transplant recipients, the mean age was youngest in black patients (P = .02); variation of mean age was not seen within HCV patients. Regarding the transplant recipients' income and insurance, most API and white patients were in the highest income quartile, whereas most black and Hispanic patients were in the lowest income group (P < .001). The most common form of payer across all racial/ethnic groupings was private insurance (P < .001). The mean length of hospitalization was longest in Hispanic patients (P = .008); they had a significantly longer stay compared with white patients (P = .02). The liver transplantations were mostly performed in teaching hospitals, located in urban areas in the West region of the United States (P < .001).
  
  
  CONCLUSIONS
  Differences were found in the HBV and HCV-associated liver transplant populations. More work needs to be done to elucidate disparities regarding black and Hispanic liver transplant recipients as they receive transplants at younger mean ages, are in lower income quartiles, and have longer lengths of hospitalization compared with other racial/ethnic groupings.
authors.affiliation: Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: P H
authors.initials: PH
authors.lastname: Lam
authors.affiliation: Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Obirieze
authors.affiliation: Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: G
authors.initials: G
authors.lastname: Ortega
authors.affiliation: Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: I
authors.initials: I
authors.lastname: Nwokeabia
authors.affiliation: Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: S
authors.initials: S
authors.lastname: Onyewu
authors.affiliation: Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Purnell
authors.affiliation: Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Samimi
authors.affiliation: Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: Weeks
authors.affiliation: Department of Pathology, Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Lee
authors.affiliation: Department of Pathology, Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: B
authors.initials: B
authors.lastname: Shokrani
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA; Howard University Cancer Center, Howard University Hospital, Washington, District of Columbia, USA.
authors.forename: W A I
authors.initials: WA
authors.lastname: Frederick
authors.affiliation: Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA.
authors.forename: C O
authors.initials: CO
authors.lastname: Callender
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA; Howard University Cancer Center, Howard University Hospital, Washington, District of Columbia, USA. Electronic address: lori.wilson@howard.edu.
authors.forename: L L
authors.initials: LL
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007297:Inpatients; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015996:Survival Rate / Q000639:trends; D066027:Transplant Recipients; D014481:United States / Q000453:epidemiology; D055815:Young Adult