Racial and Ethnic Disparities in Liver Transplantation for Alcohol-associated Liver Diseases in the United States Article Swipe
Thomas G. Cotter
,
Mack C. Mitchell
,
Mausam Patel
,
Ahmad Anouti
,
Sarah R. Lieber
,
Nicole E. Rich
,
Juan Pablo Arab
,
Luis Antonio Díaz
,
Jeremy Louissaint
,
Thomas Kerr
,
Arjmand Mufti
,
Steven I. Hanish
,
Parsia A. Vagefi
,
Madhukar S. Patel
,
Lisa B. VanWagner
,
William M. Lee
,
Jacqueline G. O’Leary
,
Amit G. Singal
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/tp.0000000000004701
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/tp.0000000000004701
Background. Emerging data suggest disparities exist in liver transplantation (LT) for alcohol-associated liver disease (ALD). As the incidence of ALD increases, we aimed to characterize recent trends in ALD LT frequency and outcomes, including racial and ethnic disparities. Methods. Using United Network for Organ Sharing/Organ Procurement and Transplantation Network data (2015 through 2021), we evaluated LT frequency, waitlist mortality, and graft survival among US adults with ALD (alcohol-associated hepatitis [AH] and alcohol-associated cirrhosis [AAC]) stratified by race and ethnicity. We used adjusted competing-risk regression analysis to evaluate waitlist outcomes, Kaplan–Meier analysis to illustrate graft survival, and Cox proportional hazards modeling to identify factors associated with graft survival. Results. There were 1211 AH and 26 526 AAC new LT waitlist additions, with 970 AH and 15 522 AAC LTs performed. Compared with non-Hispanic White patients (NHWs) with AAC, higher hazards of waitlist death were observed for Hispanic (subdistribution hazard ratio [SHR] = 1.23, 95% confidence interval [CI]: 1.16-1.32), Asian (SHR = 1.22, 95% CI:1. 01-1.47), and American Indian/Alaskan Native (SHR = 1.42, 95% CI: 1.15-1.76) candidates. Similarly, significantly higher graft failures were observed in non-Hispanic Black (HR = 1.32, 95% CI: 1.09-1.61) and American Indian/Alaskan Native (HR = 1.65, 95% CI: 1.15-2.38) patients with AAC than NHWs. We did not observe differences in waitlist or post-LT outcomes by race or ethnicity in AH, although analyses were limited by small subgroups. Conclusions. Significant racial and ethnic disparities exist for ALD LT frequency and outcomes in the United States. Compared with NHWs, racial and ethnic minorities with AAC experience increased risk of waitlist mortality and graft failure. Efforts are needed to identify determinants for LT disparities in ALD that can inform intervention strategies.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/tp.0000000000004701
- OA Status
- green
- Cited By
- 29
- References
- 35
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4381469896
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4381469896Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1097/tp.0000000000004701Digital Object Identifier
- Title
-
Racial and Ethnic Disparities in Liver Transplantation for Alcohol-associated Liver Diseases in the United StatesWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-06-21Full publication date if available
- Authors
-
Thomas G. Cotter, Mack C. Mitchell, Mausam Patel, Ahmad Anouti, Sarah R. Lieber, Nicole E. Rich, Juan Pablo Arab, Luis Antonio Díaz, Jeremy Louissaint, Thomas Kerr, Arjmand Mufti, Steven I. Hanish, Parsia A. Vagefi, Madhukar S. Patel, Lisa B. VanWagner, William M. Lee, Jacqueline G. O’Leary, Amit G. SingalList of authors in order
- Landing page
-
https://doi.org/10.1097/tp.0000000000004701Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
-
https://www.ncbi.nlm.nih.gov/pmc/articles/12169589Direct OA link when available
- Concepts
-
Medicine, Hazard ratio, Liver transplantation, Proportional hazards model, Internal medicine, Liver disease, Confidence interval, Ethnic group, Transplantation, Cirrhosis, Alcoholic liver disease, Demography, Sociology, AnthropologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
29Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 13, 2024: 14, 2023: 1Per-year citation counts (last 5 years)
- References (count)
-
35Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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