Gut Reaction is a blog by staff writer Cole Petrochko that looks at trending conversations in gastroenterological medicine.
Bucking a trend in claims of greater equality in transplant outcomes, researchers recently found that young whites had better survival out to 10 years following liver transplant than black children and teens.
There was a nearly 25 percentage point difference in survival rates at 10 years between teenage and pediatric white and black liver transplant patients (84% versus 60%), and a 35 percentage point difference between nonblack patients and nonwhite patients (84% versus 49%), according to Rachel Patzer, PhD, of Emory University School of Medicine in Atlanta, and colleagues.
The disparities in graft failure and mortality remained significant after adjustment for socioeconomic, clinical, and demographic characteristics, they wrote online in the journal Liver Transplantation.
"The degree of racial/ethnic and socioeconomic inequality found in the Southeastern U.S. is reflected in the findings of this study," they concluded, adding that "minorities had almost four times the morality rates of whites and two to three times the graft failure rate of whites, even after adjustments for relevant clinical and socioeconomic factors (HR 3.14, 95% CI 1.01-9.78)."
They said that these findings "likely involve unmeasured differences in socioeconomic status affecting pre-transplant and post-transplant disease states."
Recent research has mostly found rates of disparity between races have leveled off.
For example, Anna Lok, MD, of the University of Michigan, and colleagues found that white patients had a higher rate of 4-year hepatitis B recurrence following living transplant, but that other issues, such as wait list time and post-transplantation survival, were not different between races.
Similarly, a study by Nilay Shah, PhD, and colleagues at the Mayo Clinic in Rochester, Minn., showed no significant differences in 1-, 5-, or 10-year outcomes for survival in orthotopic liver transplantation among whites, blacks, and patients of other races.
Patzer noted that their study was limited by a small sample size (n=208 patients), length of follow-up, and lack of powering in the results.
They also noted use of a single center as a limitation, though the fact that she found disparities by race between the two studies seems to be an area for further study, particularly given trends in national data.