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Clin Transplant. 2014 Jul;28(7):755-61. doi: 10.1111/ctr.12374. Epub 2014 May 21.

Combination of racial/ethnic and etiology/disease-specific factors is associated with lower survival following liver transplantation in African Americans: an analysis from UNOS/OPTN database.

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  • 1Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.

Abstract

Higher rates of hepatitis C virus (HCV) recurrence and lower response to HCV antiviral therapy contribute to the lower post-liver transplantation (LT) survival among African Americans with HCV. The current study aims to evaluate race/ethnicity-specific and etiology-specific factors contributing to lower post-LT survival among African Americans in the USA. The 2002-2012 United Network for Organ Sharing registry was utilized to evaluate race/ethnicity-specific post-LT survival among patients with HCV, hepatocellular carcinoma (HCC), alcoholic liver disease (ALD), non-alcoholic steatohepatitis, and cryptogenic cirrhosis. From 2002 to 2012, HCV was the leading indication for LT. While African Americans accounted for 9.5% of all LT during this period, they had the lowest overall and etiology-specific five-yr post-LT survival. On multivariate Cox proportional hazards modeling, African Americans had significantly lower post-LT survival compared with non-Hispanic whites among patients with HCV (HR, 1.30; 95% CI, 1.19-1.41), HCC (HR, 1.49; 95% CI, 1.25-1.79), and ALD (HR, 1.52; 95% CI, 1.19-1.94). In conclusion, African Americans had the lowest post-LT survival among patients with HCV, HCC, and ALD. Race/ethnicity and the etiology of chronic liver disease were observed to have a combined detrimental effect leading to lower survival following LT in African Americans.

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

KEYWORDS:

alcoholic liver disease; hepatitis C; hepatocellular carcinoma; racial disparities

PMID:
24750171
[PubMed - indexed for MEDLINE]
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