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Racial Disparities in Liver Transplantation for Hepatocellular Carcinoma in the United States: An Update

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A Correction to this article was published on 13 October 2023

This article has been updated

Abstract

Background

Previous studies have demonstrated a disparity in liver transplantation (LT) for hepatocellular carcinoma (HCC) among races in the United States (U.S.).

Aims

We aimed to update the literature on the odds, trends, and complications of LT in the treatment of hepatocellular carcinoma (HCC), among individuals of different racial backgrounds.

Methods

This is a nationwide study of adult individuals admitted for LT with a primary diagnosis of HCC. Using weighted data from the National Inpatient Sample (NIS) database, we compared the odds of LT among different races from 2016 to 2020, using a multivariate regression analysis. We further assessed the trends and outcomes of LT among races.

Results

A total of 112,110 adult were hospitalized with a primary diagnosis of HCC. 3020 underwent LT. When compared to Whites, the likelihood of undergoing LT for HCC was significantly reduced in Blacks (OR = 0.60, 95% CI = 0.46–0.78). Further, Blacks had increased mortality rates (7% in Blacks vs. 1% in Whites, p < 0.001), sepsis (11% in Blacks vs. 3% in Whites, p = 0.015), and acute kidney injury (AKI) (54% in Blacks vs. 31% in Whites, p < 0.001) following LT.

Conclusions

Individuals identifying as Blacks were less likely to undergo LT for HCC, and more likely to develop complications. Further initiatives are warranted to mitigate the existing disparities among racial groups.

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Funding

There was no explicit support or funding for this research.

Author information

Authors and Affiliations

  1. Department of Medicine, Lincoln Medical Center/Weill Cornell Medicine, New York, NY, USA

    Yassine Kilani, Yazan Aljabiri & Haris Sohail

  2. Department of Medicine, SIU School of Medicine, Springfield, IL, USA

    Syeda Ashna Fatima Kamal

  3. Department of Medicine, Jacobi Medical Center, New York, NY, USA

    Fnu Vikash & Sindhu Vikash

  4. Department of Medicine, NYU Langone, New York, NY, USA

    Mohammad Aldiabat

  5. Department of Medicine, University of Missouri, Kansas City, MO, USA

    Saqr Alsakarneh

  6. Department of Medicine, Brooklyn Hospital Center, New York, NY, USA

    Vikash Kumar

  7. Department of Gastroenterology, Saint Louis University, Saint Louis, MO, USA

    Laith Numan

  8. Department of Transplant Hepatology, University of South Florida, Tampa, FL, USA

    Kawtar Al Khalloufi

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  1. Yassine Kilani
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Contributions

YK: Conceptualization; Methodology; Formal analysis and investigation; Writing—Original draft preparation; Writing—review, and editing. SAFK: Writing—Original draft preparation and Writing—Original draft preparation. FV: Original draft preparation and Writing—Original draft preparation. SV: Original draft preparation and Writing—Original draft preparation. MA: Writing—review, and editing. SA: Writing—review, and editing. YA: Writing – review, and editing. HS: Writing—review, and editing. VK Writing—review, and editing. LN, MD: Writing—review, and editing. AKK, MD: Conceptualization, Formal analysis and investigation, Writing—review, and editing, Supervision.

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Correspondence to Yassine Kilani.

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The original online version of this article was revised: The mistakes in Discussion and Conclusion sections have been corrected.

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Kilani, Y., Kamal, S.A.F., Vikash, F. et al. Racial Disparities in Liver Transplantation for Hepatocellular Carcinoma in the United States: An Update. Dig Dis Sci 68, 4050–4059 (2023). https://doi.org/10.1007/s10620-023-08084-z

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