Disparities in Liver Transplant Outcomes: Race/Ethnicity and Individual- and Neighborhood-Level Socioeconomic Status.
Niharika Gummaraj Srinivas, Ye Chen, Angie Mae Rodday and 1 others
PMID 39192612WHAT IT FOUND
In 55,688 liver transplant recipients, Black patients, public insurance, and high school or less were linked to higher 10-year graft failure or death; Asian and Hispanic patients were linked to lower risk.
Neighborhood deprivation did not remain linked once these patient factors were considered.
Key findings
01In the adjusted model with race/ethnicity and all SES factors, Black recipients had a higher rate of graft failure or death than White recipients (HR 1.27, p < .0001), while Asian and Hispanic recipients had lower rates (HR 0.83, p = .0001 and HR 0.88, p < .0001).
02Public insurance holders and those who completed high school or less had a higher rate of graft failure or death than private insurance holders and those with more than high school education (HR 1.14, p < .0001 and HR 1.06, p = .002).
03Neighborhood SDI scores were significantly associated with the outcome in single-factor models but not when race/ethnicity and all SES factors were included in one model.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used complete case data and excluded patients with missing values on included variables. Education and insurance were used as proxies for individual socioeconomic status and may not capture the full socioeconomic spectrum. Neighborhood deprivation was measured by ZIP-code SDI at transplant, which may not capture the immediate neighborhood, may miss access to care and health behaviors, and may be inaccurate if patients moved after transplant. The data did not include genetics, distance to transplant center, or other potential factors.
The easy way to misread this
Do not conclude that race, education, insurance, or neighborhood deprivation caused graft failure or death. This was an observational registry analysis, and neighborhood deprivation was not independently associated once race/ethnicity and individual-level SES factors were included.