BACKGROUND: There is significant evidence to suggest that long-term survival after renal transplantation is significantly lower in African Americans than in other races. We aimed to establish whether there was a difference in survival in African Americans compared with other races after orthotopic liver transplantation (OLT) and whether race was an independent predictor of survival. METHODS: We collected data from the United Network of Organ Sharing transplant registry for all liver transplants done between 1988 and 1996 in the USA. We also recorded information on age, sex, race, blood group, and cause of death for the donors and recipients. FINDINGS: 2-year graft survival was significantly lower for African Americans (601 of 884, 68%) and Asians (266 of 416, 64%) compared with white Americans (8703 of 11762, 74%) and Hispanics (878 of 1220, 72%). 2-year and 5-year patient survival were significantly lower for African Americans (654 of 884 [74%], 270 of 565 [48%]) and Asians (287 of 416 [69%], 92 of 252 [37%]) compared with white Americans (9786 of 11762 [83%], 4357 of 7514 [58%]) and Hispanics (964 of 1220 [79%], 341 of 657 [52%]). Compared with white Americans, African American (hazard ratio 1.36, 95% CI 1.16-1.60, p<0.0001) and Asian (1.25, 1.01-1.56, p=0.03) race were independent predictors of poor survival at 2 years. INTERPRETATION: African Americans and Asians have a worse outcome after OLT compared with white Americans and Hispanics. The higher rate of chronic rejection in African Americans and a relatively worse outcome in other minority races merits further examination.
BACKGROUND: There is significant evidence to suggest that long-term survival after renal transplantation is significantly lower in African Americans than in other races. We aimed to establish whether there was a difference in survival in African Americans compared with other races after orthotopic liver transplantation (OLT) and whether race was an independent predictor of survival. METHODS: We collected data from the United Network of Organ Sharing transplant registry for all liver transplants done between 1988 and 1996 in the USA. We also recorded information on age, sex, race, blood group, and cause of death for the donors and recipients. FINDINGS: 2-year graft survival was significantly lower for African Americans (601 of 884, 68%) and Asians (266 of 416, 64%) compared with white Americans (8703 of 11762, 74%) and Hispanics (878 of 1220, 72%). 2-year and 5-year patient survival were significantly lower for African Americans (654 of 884 [74%], 270 of 565 [48%]) and Asians (287 of 416 [69%], 92 of 252 [37%]) compared with white Americans (9786 of 11762 [83%], 4357 of 7514 [58%]) and Hispanics (964 of 1220 [79%], 341 of 657 [52%]). Compared with white Americans, African American (hazard ratio 1.36, 95% CI 1.16-1.60, p<0.0001) and Asian (1.25, 1.01-1.56, p=0.03) race were independent predictors of poor survival at 2 years. INTERPRETATION: African Americans and Asians have a worse outcome after OLT compared with white Americans and Hispanics. The higher rate of chronic rejection in African Americans and a relatively worse outcome in other minority races merits further examination.
Authors: Varun Saxena; Jennifer C Lai; Jacqueline G O'Leary; Elizabeth C Verna; Robert S Brown; R Todd Stravitz; James F Trotter; Kartik Krishnan; Norah A Terrault Journal: Liver Transpl Date: 2012-05 Impact factor: 5.799
Authors: Jennifer E Layden; Scott J Cotler; Shellee A Grim; Michael J Fischer; Michael R Lucey; Nina M Clark Journal: Transplantation Date: 2012-02-27 Impact factor: 4.939
Authors: Claudia A Couto; Claudio L Gelape; Iliana B Doycheva; Jonathan K Kish; Paul Martin; Cynthia Levy Journal: Hepatol Int Date: 2012-12-27 Impact factor: 6.047
Authors: Jennifer E Layden; Bamidele O Tayo; Scott J Cotler; Nina M Clark; Kristine Baraoidan; Scott L Friedman; Richard S Cooper Journal: Transplantation Date: 2014-05-27 Impact factor: 4.939
Authors: Yong Han Paik; Kwan Sik Lee; Kwang Hyub Han; Kun Hoon Song; Myoung Hwan Kim; Byung Soo Moon; Sang Hoon Ahn; Se Joon Lee; Hyo Jin Park; Dong Ki Lee; Chae Yoon Chon; Sang In Lee; Young Myoung Moon Journal: Yonsei Med J Date: 2005-06-30 Impact factor: 2.759