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Racial and ethnic disparities in post-liver transplant outcomes for patients with acute-on-chronic liver failure: An analysis of the UNOS database.
Lee, David Uihwan; Shaik, Mohammed Rifat; Bhowmick, Kuntal; Fan, Gregory Hongyuan; Schuster, Kimberly; Yousaf, Abdul; Refaat, Mohamed; Shaik, Nishat Anjum; Lee, Ki Jung; Yang, Sarah; Bahadur, Aneesh; Urrunaga, Nathalie H.
Afiliación
  • Lee DU; Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Shaik MR; Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Bhowmick K; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
  • Fan GH; Liver Center, Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts, USA.
  • Schuster K; Liver Center, Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts, USA.
  • Yousaf A; University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA.
  • Refaat M; University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA.
  • Shaik NA; Department of Medicine, Saint Louis University, Saint Louis, Missouri, USA.
  • Lee KJ; Liver Center, Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts, USA.
  • Yang S; Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Bahadur A; Liver Center, Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts, USA.
  • Urrunaga NH; Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Aliment Pharmacol Ther ; 60(8): 1087-1109, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39185724
ABSTRACT

BACKGROUND:

The incidence of hospitalisations related to acute-on-chronic liver failure (ACLF) is increasing. Liver transplantation (LT) remains the definitive treatment for the condition.

AIM:

To evaluate the influence of race and ethnicity on LT outcomes in ACLF.

METHODS:

We conducted a retrospective analysis utilising LT data from the United Network for Organ Sharing (UNOS) database. White patients served as the control group and patients of other races were compared at each ACLF grade. The primary outcomes assessed were graft failure and all-cause mortality.

RESULTS:

Blacks exhibited a higher all-cause mortality (Grade 1 aHR 1.36, 95% CI 1.18-1.57, p < 0.001; Grade 2 aHR 1.27, 95% CI 1.08-1.48, p = 0.003; Grade 3 aHR 1.19, 95% CI 1.04-1.37, p = 0.01) and graft failure (Grade 1 aHR 2.05, 95% CI 1.58-2.67, p < 0.001; Grade 2 aHR 1.91, 95% CI 1.43-2.54, p < 0.001; Grade 3 aHR 1.50, 95% CI 1.15-1.96, p = 0.002). Hispanics experienced a lower all-cause mortality at grades 1 and 3 (Grade 1 aHR 0.83, 95% CI 0.72-0.96, p = 0.01; Grade 3 aHR 0.80, 95% CI 0.70-0.91, p < 0.001) and Asians with severe ACLF demonstrated decreased all-cause mortality (Grade 3 aHR 0.55, 95% CI 0.42-0.73, p < 0.001).

CONCLUSION:

Black patients experienced the poorest outcomes and Hispanic and Asian patients demonstrated more favourable outcomes compared to Whites.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Insuficiencia Hepática Crónica Agudizada Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Aliment Pharmacol Ther Asunto de la revista: FARMACOLOGIA / GASTROENTEROLOGIA / TERAPIA POR MEDICAMENTOS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Insuficiencia Hepática Crónica Agudizada Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Aliment Pharmacol Ther Asunto de la revista: FARMACOLOGIA / GASTROENTEROLOGIA / TERAPIA POR MEDICAMENTOS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido