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Monday, February 12th, 2018
Table of Contents

1 Introduction
5 PMID
 [F] Diseases Research  / PubMed Research Articles  /
Increased Waitlist Mortality and Lower Rate for Liver Transplantation in Hispanic Patients with Primary Biliary Cholangitis.

PubMed

 

Resource

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Feb ; ()

Authors

Cholankeril G1; Gonzalez HC2; Satapathy S3; Gonzalez SA4; Hu M5; Khan MA6; Yoo ER7; Li AA8; Kim D9; Nair S10; Wong RJ11; Kwo PY12; Harrison SA13; Younossi ZM14; Lindor KD15; Ahmed A16;

Author Information
  • 1Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, United States.
  • 2Department of Transplant Surgery, Methodist University Hospital, University of Tennessee Health Science Center, Memphis TN, United States.
  • 3Department of Transplant Surgery, Methodist University Hospital, University of Tennessee Health Science Center, Memphis TN, United States.
  • 4Baylor Simmons Transplant Institute, Fort Worth, TX, United States.
  • 5Department of Biostatistics, Brown University School of Public Health, Providence, RI, United States.
  • 6Department of Transplant Surgery, Methodist University Hospital, University of Tennessee Health Science Center, Memphis TN, United States.
  • 7Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, United States.
  • 8Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, United States.
  • 9Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, United States.
  • 10Department of Transplant Surgery, Methodist University Hospital, University of Tennessee Health Science Center, Memphis TN, United States.
  • 11Division of Gastroenterology and Hepatology, Alameda Health System, Highland Hospital, Oakland, CA, United States.
  • 12Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, United States.
  • 13Radcliffe Department of Medicine, University of Oxford, United Kingdom.
  • 14Department of Medicine, Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, United States.
  • 15Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Arizona State University, AZ, United States.
  • 16Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, United States. Electronic address: aijazahmed@stanford.edu.

Abstract

BACKGROUND & AIMS: Data on the differences in ethnicity and race among patients with primary biliary cholangitis (PBC) awaiting liver transplantation (LT) are limited. We evaluated liver transplant waitlist trends and outcomes based on ethnicity and race in patients with PBC in the United States.

METHODS: Using the United Network for Organ Sharing (UNOS) registry, we collected data on patients with PBC on the liver transplant waitlist, and performed analysis with a focus on ethnicity and race-based variations clinical manifestations, waitlist mortality and LT rates from 2000 to 2014. Outcomes were adjusted for demographics, complications of portal hypertension, and Model for End-stage Liver Disease score at time of waitlist registration.

RESULTS: Although the number of Caucasian PBC waitlist registrants and additions decreased from 2000 to 2014, there were no significant changes in the number of Hispanic PBC waitlist registrants and additions each year. The proportion of Hispanic patients with PBC on the liver transplant waitlist increased from 10.7% in 2000 to 19.3% in 2014. Hispanics had the highest percentage of waitlist deaths (20.8%) of any ethnicity or race evaluated. After adjusting for demographic and clinical characteristics, Hispanic patients with PBC had the lowest overall rate for undergoing LT (adjusted hazard ratio, 0.71; 95% CI, 0. 60-0.83; P<.001) and a significantly higher risk of death while on the waitlist, compared to Caucasians (adjusted hazard ratio, 1.41; 95% CI, 1.15-1.74; P<.001). Furthermore, Hispanic patients with PBC had the highest proportion of waitlist removals due to clinical deterioration.

CONCLUSION: In an analysis of data from UNOS registry focusing on outcomes, we observed differences in rates of LT and liver transplant waitlist mortality of Hispanic patients compared with Caucasian patients with PBC. Further studies are needed to improve our understanding of ethnicity and race-based differences in progression of PBC.

Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

PMID

29427734

Others

Publication Type: Journal Article


This article is licensed under the the National Library of Medicine License. It uses material from the PubMed National Library of Medicine Data.


Last Modified:   2016-03-27


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