PMID- 33444709
OWN - NLM
STAT- MEDLINE
DCOM- 20210928
LR  - 20221207
IS  - 1879-1190 (Electronic)
IS  - 1072-7515 (Print)
IS  - 1072-7515 (Linking)
VI  - 232
IP  - 4
DP  - 2021 Apr
TI  - Racial Disparity in Liver Transplantation Listing.
PG  - 526-534
LID - S1072-7515(21)00001-6 [pii]
LID - 10.1016/j.jamcollsurg.2020.12.021 [doi]
AB  - BACKGROUND: Previous studies have demonstrated disparities in transplantation for 
      women, non-Caucasians, the uninsured or publicly insured, and rural populations. 
      We sought to correlate transplant center characteristics with patient access to 
      the waiting list and liver transplantation. We hypothesized that liver transplant 
      centers vary greatly in providing equitable access to the waiting list and liver 
      transplantation. STUDY DESIGN: Center-specific, adult, deceased-donor liver 
      transplant and waitlist data for the years 2013 to 2018 were obtained from the 
      United Network for Organ Sharing. Waitlist race/ethnicity distributions from 
      liver transplant centers performing >/= 250 transplants over this period (n = 109) 
      were compared with those of their donor service area, as calculated from 5-year 
      US Census Bureau estimates of 2017. Center-specific characteristics correlating 
      with disparities were analyzed using a linear regression model with a log 
      transformed outcome. RESULTS: Non-Hispanic Blacks (NHBs) are under-represented in 
      liver transplant listing compared with center donation service area (88/109, 
      81%), whereas, non-Hispanic Whites are over-represented (65/109, 58%) (p < 
      0.0001). Hispanics were also under-represented on the waitlist at the majority of 
      transplant centers (68/109, 62%) (p = 0.02). Although the racial/ethnic 
      distribution of transplantation is more reflective of the waitlist, there is a 
      higher than expected rate of transplantation for NHBs compared to the waitlist. 
      Predictors of disparity in listing include percentage of transplant recipients at 
      the center who had private insurance, racial composition of the donation service 
      area, and the distance recipients had to travel for transplant. CONCLUSIONS: 
      Non-Hispanic Blacks are listed for liver transplantation less than would be 
      expected. Once listed, however, racial disparities in transplantation are greatly 
      diminished. Improvements in access to adequate health insurance appear to be 
      essential to diminishing disparities in access to this life-saving care.
CI  - Copyright (c) 2021 American College of Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Warren, Curtis
AU  - Warren C
AD  - Department of Surgery, University of Florida, Gainesville, FL.
FAU - Carpenter, Anne-Marie
AU  - Carpenter AM
AD  - Department of Surgery, University of Florida, Gainesville, FL.
FAU - Neal, Daniel
AU  - Neal D
AD  - Department of Surgery, University of Florida, Gainesville, FL.
FAU - Andreoni, Kenneth
AU  - Andreoni K
AD  - Department of Surgery, University of Florida, Gainesville, FL.
FAU - Sarosi, George
AU  - Sarosi G
AD  - Department of Surgery, University of Florida, Gainesville, FL.
FAU - Zarrinpar, Ali
AU  - Zarrinpar A
AD  - Department of Surgery, University of Florida, Gainesville, FL. Electronic 
      address: Ali.Zarrinpar@surgery.ufl.edu.
LA  - eng
GR  - K08 DK113244/DK/NIDDK NIH HHS/United States
GR  - R01 MD012579/MD/NIMHD NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20210112
PL  - United States
TA  - J Am Coll Surg
JT  - Journal of the American College of Surgeons
JID - 9431305
SB  - IM
CIN - J Am Coll Surg. 2021 Apr;232(4):534-535. PMID: 33771310
MH  - Black People/statistics & numerical data
MH  - Educational Status
MH  - End Stage Liver Disease/diagnosis/*surgery
MH  - Female
MH  - Health Services Accessibility/economics/*statistics & numerical data
MH  - Healthcare Disparities/economics/*statistics & numerical data
MH  - Hispanic or Latino/statistics & numerical data
MH  - Humans
MH  - Insurance Coverage/statistics & numerical data
MH  - Liver Transplantation/economics/*statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Severity of Illness Index
MH  - United States
MH  - Waiting Lists
MH  - White People/statistics & numerical data
PMC - PMC8143858
MID - NIHMS1699240
EDAT- 2021/01/15 06:00
MHDA- 2021/09/29 06:00
PMCR- 2021/05/24
CRDT- 2021/01/14 20:12
PHST- 2020/11/30 00:00 [received]
PHST- 2020/12/01 00:00 [accepted]
PHST- 2021/01/15 06:00 [pubmed]
PHST- 2021/09/29 06:00 [medline]
PHST- 2021/01/14 20:12 [entrez]
PHST- 2021/05/24 00:00 [pmc-release]
AID - S1072-7515(21)00001-6 [pii]
AID - 10.1016/j.jamcollsurg.2020.12.021 [doi]
PST - ppublish
SO  - J Am Coll Surg. 2021 Apr;232(4):526-534. doi: 10.1016/j.jamcollsurg.2020.12.021. 
      Epub 2021 Jan 12.