Novel research reveals racial and socioeconomic disparities among pediatric liver transplant patients. Findings published in Liver Transplantation,
a journal of the American Association for the Study of Liver Diseases
and the International Liver Transplantation Society, indicate that graft
and patient survival was higher in white children than minorities.
For patients with end-stage liver disease (ESLD) the
only treatment option for survival is liver transplantation. Studies
show that over the last 30 years pediatric patient survival, at one year
following liver transplant, is 90% compared to 70% prior to 1980.
Experts suggest that as survival rates improve, understanding racial and
socioeconomic differences in pediatric populations are important
factors to consider for overall health status.
“Little is known about the impact of race, ethnicity
and socioeconomic status disparities on outcomes after liver
transplantation among pediatric and adolescent recipients,” explains
first author Rekha Thammana, MD of Emory University Department of
Medicine in Atlanta, GA. “Our study is the first to investigation the
impact of race and socioeconomic status on graft and patient survival
among white and minority children.”
Researchers included 208 liver transplant recipients,
aged 22 or younger, who were transplanted at Children’s Hospital of
Atlanta between January 1998 and December 2008. Participants were
followed through November 2011. Data from the United Network for Organ
Sharing (UNOS) on transplant outcomes and donor characteristics was
linked with Georgia Transplant Foundation financial aid data to examine
the contribution of socioeconomic status to the observed racial
Results show that 51% of transplant recipients were
white, 35% were black and 14% were other races or ethnicities. At 1, 3,
5, and 10 years following liver transplant the graft and patient
survival was higher among white children compared to the minority
children. The 10-year graft survival was 84% for white, 60% among black
and 49% for the remaining minority patients. Patient survival at 10
years post-transplant was 92%, 65%, and 76% among whites, blacks, and
other races, respectively.
Further analyses show that graft failure and
mortality rates remained higher among minority groups compared to white
children after accounting for differences in demographic, clinical, and
socioeconomic factors. “While our study determined differences in
post-transplant outcomes between minority and white pediatric liver
transplant recipients, we were unable to fully explain the reason for
these disparities,” concluded senior author Rachel Patzer, PhD, MPH with
the Division of Transplantation at Emory University. “Further
investigation of the reasons for racial and ethnic differences,
particularly on a national level, is necessary to indentify
interventions that may help reduce disparities in pediatric liver
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Full citation: Racial and Socioeconomic
Disparities in Pediatric and Young Adult Liver Transplant Outcomes.”
R.V. Thammana , S. J. Knechtle, R. Romero, T. G. Heffron, C. T. Daniels
and R. E. Patzer. Liver Transplantation; (DOI: 10.1002/lt.23769)
Author Contact: Media wishing to speak with Dr. Patzer may contact Sean Moore with the Department of Surgery at firstname.lastname@example.org. Alternatively, you may contact email@example.com or +1 404-727-6216.
About the Journal
Liver Transplantation is published by Wiley on behalf of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.
Since the first application of liver transplantation in a clinical
situation was reported more than twenty years ago, there has been a
great deal of growth in this field and more is anticipated. As an
official publication of the AASLD and the ILTS,
Liver Transplantation delivers current, peer-reviewed articles on
surgical techniques, clinical investigations and drug research — the
information necessary to keep abreast of this evolving specialty. For
more information, please visit http://wileyonlinelibrary.com/journal/lt.
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