Differences in Racial and Sex Disparities in Liver Transplantation Outcomes Between Older and Younger Adult Recipients.
Johns Hopkins University, Baltimore
Meeting: 2017 American Transplant Congress
Abstract number: C70
Keywords: African-American, Elderly patients, Graft survival, Liver transplantation
Session Information
Session Name: Poster Session C: Disparity in Access and Outcomes for Solid Organ Transplantation
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: More older adults underwent liver transplantation (LT) in the past decade. While racial and sex disparities in LT outcomes have been reported in general, it is possible that the biological or social factors driving these disparities affect older and younger adults differently. The goal of this study was to investigate whether racial and sex disparities in LT outcomes differ between older and younger adult recipients.
Method: From SRTR we identified 58,277 adult deceased donor adult LT recipients (2003-2015). Risks of mortality and graft loss were estimated by using Cox proportional hazard models adjusted for recipient, LT, and donor factors. We tested whether older/younger age modified the associations between race, sex and outcomes.
Results: 7,694 older recipients (>=65 years) and 50,583 younger recipients (18-64 years) were identified. Among younger LT recipients, AAs had a 27% higher risk of mortality (adjusted HR=1.27, 95%CI:1.20-1.35) and a 30% higher risk of graft loss (aHR=1.30, 95%CI:1.23-1.36). However, among older LT recipients, AAs had similar outcomes to Caucasians. Hispanic and Asian recipients were at lower risk regardless of age. Among younger LT recipients, female had a 4% higher risk of mortality but similar graft survival compared with male. However, among older LT recipients, older female had decreased risks of both mortality (aHR=0.91,95%CI:0.84-0.99) and graft loss (aHR=0.90,95%CI:0.83-0.98).
Conclusion: AA racial disparities were seen only in younger LT recipients, with no racial differences among older LT recipients. Female sex disparities were also only seen in younger LT recipients, while older female LT recipients actually had better outcomes. The potential differences in biological or social factors driving these differences in outcomes merit a deeper understanding. 
CITATION INFORMATION: Huang Q, Haugen C, Luo X, Massie A, McAdams-DeMarco M, Segev D. Differences in Racial and Sex Disparities in Liver Transplantation Outcomes Between Older and Younger Adult Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Huang Q, Haugen C, Luo X, Massie A, McAdams-DeMarco M, Segev D. Differences in Racial and Sex Disparities in Liver Transplantation Outcomes Between Older and Younger Adult Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/differences-in-racial-and-sex-disparities-in-liver-transplantation-outcomes-between-older-and-younger-adult-recipients/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress