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Racial and socioeconomic disparities in pediatric and young adult liver transplant outcomes.

Publication ,  Journal Article
Thammana, RV; Knechtle, SJ; Romero, R; Heffron, TG; Daniels, CT; Patzer, RE
Published in: Liver Transpl
January 2014

Racial and socioeconomic disparities exist in liver transplantation (LT) outcomes among adults, but little research exists for pediatric LT populations. We examined racial differences in graft survival and mortality within a retrospective cohort of pediatric and young adult LT recipients at a large children's transplant center in the Southeast between 1998 and 2011. The association between race/ethnicity and rates of graft failure and mortality was examined with Cox proportional hazards models that were adjusted for demographic and clinical factors as well as individual-level and census tract-level socioeconomic status (SES). Among the 208 LT recipients, 51.0% were white, 34.6% were black, and 14.4% were other race/ethnicity. Graft survival and patient survival were higher for whites versus minorities 1, 3, 5, and 10 years after transplantation. The 10-year graft survival rates were 84% [95% confidence interval (CI) = 76%-91%] for white patients, 60% (95% CI = 46%-74%) for black patients, and 49% (95% CI = 23%-77%) for other race/ethnicity patients. The 10-year patient survival rates were 92% (95% CI = 84%-96%), 65% (95% CI = 52%-79%), and 76% (95% CI = 54%-97%) for the white, black, and other race/ethnicity groups, respectively. In analyses adjusted for demographic, clinical, and socioeconomic characteristics, the rates of graft failure [black: hazard ratio (HR) = 2.59, 95% CI = 1.29-5.45; other: HR = 3.01, 95% CI = 1.23-7.35] and mortality (black: HR = 4.24, 95% CI = 1.54-11.69; other: HR = 3.09, 95% CI = 0.78-12.19) were higher for minority groups versus whites. In conclusion, at a large pediatric transplant center in the Southeastern United States, racial/ethnic disparities exist in pediatric and young adult LT outcomes that are not fully explained by measured SES and clinical factors.

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Published In

Liver Transpl

DOI

EISSN

1527-6473

Publication Date

January 2014

Volume

20

Issue

1

Start / End Page

100 / 115

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Survival Rate
  • Surgery
  • Social Class
  • Retrospective Studies
  • Residence Characteristics
  • Racial Groups
  • Proportional Hazards Models
  • Minority Groups
 

Citation

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Thammana, R. V., Knechtle, S. J., Romero, R., Heffron, T. G., Daniels, C. T., & Patzer, R. E. (2014). Racial and socioeconomic disparities in pediatric and young adult liver transplant outcomes. Liver Transpl, 20(1), 100–115. https://doi.org/10.1002/lt.23769
Thammana, Rekha V., Stuart J. Knechtle, Rene Romero, Thomas G. Heffron, Caroline T. Daniels, and Rachel E. Patzer. “Racial and socioeconomic disparities in pediatric and young adult liver transplant outcomes.Liver Transpl 20, no. 1 (January 2014): 100–115. https://doi.org/10.1002/lt.23769.
Thammana RV, Knechtle SJ, Romero R, Heffron TG, Daniels CT, Patzer RE. Racial and socioeconomic disparities in pediatric and young adult liver transplant outcomes. Liver Transpl. 2014 Jan;20(1):100–15.
Thammana, Rekha V., et al. “Racial and socioeconomic disparities in pediatric and young adult liver transplant outcomes.Liver Transpl, vol. 20, no. 1, Jan. 2014, pp. 100–15. Pubmed, doi:10.1002/lt.23769.
Thammana RV, Knechtle SJ, Romero R, Heffron TG, Daniels CT, Patzer RE. Racial and socioeconomic disparities in pediatric and young adult liver transplant outcomes. Liver Transpl. 2014 Jan;20(1):100–115.
Journal cover image

Published In

Liver Transpl

DOI

EISSN

1527-6473

Publication Date

January 2014

Volume

20

Issue

1

Start / End Page

100 / 115

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Survival Rate
  • Surgery
  • Social Class
  • Retrospective Studies
  • Residence Characteristics
  • Racial Groups
  • Proportional Hazards Models
  • Minority Groups