A Qualitative Comparison of Declined Hispanic and Non-Hispanic Living Liver Donor Candidates at a High-Volume Urban Transplant Center

D. Toy¹, B. Horwich¹, A. Mulgaonkar¹, A. Padilla², J. L. Dodge³, N. Kaur⁴, H. Han³

¹Department of Medicine, University of Southern California, Los Angeles, CA, ²USC Transplant Institute, University of Southern California, Los Angeles, CA, ³Division of Gastrointestinal and Liver Diseases, University of Southern California, Los Angeles, CA, ⁴Department of Surgery, University of Southern California, Los Angeles, CA

Meeting: 2022 American Transplant Congress

Abstract number: 1763

Keywords: Hispanic, Liver transplantation, Living donor, Organ Selection/Allocation

Topic: Clinical Science » Liver » 58 - Liver: Living Donor Liver Transplant and Partial Grafts

Session Information

Session Name: Liver: Living Donor Liver Transplant and Partial Grafts

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: To compare Hispanic and non-Hispanic living liver donor candidates who were declined by a multidisciplinary selection committee at a large urban transplant center.

*Methods: The Living Liver Donor Referrals Database was reviewed between December 1, 2017 and August 31, 2021 for applicants (n = 195) who completed a questionnaire and clinic evaluation, were presented to selection committee and formally approved/declined to serve as living donors. Statistical analysis was performed using Student’s t-test and chi-squared test.

*Results: Of 1,689 living liver donor applicants, 11.5% (n = 195) were presented to the committee, where nearly half were declined (47.2%, n = 92). Among those declined, half were Hispanic and half were non-Hispanic. When comparing reasons for decline, most Hispanics were declined due to fatty liver concerns (35% v. 22%, p = 0.39) in comparison to non-Hispanics. Most non-Hispanics were declined due to anatomy or other medical history (50% v. 30%, p = 0.39). Additional reasons for decline when comparing Hispanic and non-Hispanic candidates were similar: application withdrawal (24% v. 20%, p = 0.39), social history (7% v. 6%, p = 0.39), recipient transplanted (4% v. 2%, p = 0.39). Declined Hispanic and non-Hispanic donor candidates were commonly family members (80% v. 58.7%, p = 0.08), although more than one quarter were friends of intended recipients among declined non-Hispanics (28.3% v. 15.6%, p = 0.08). Some donor candidates were presented multiple times. There was no difference when comparing mean number of presentations to the committee among declined Hispanic and non-Hispanics donor candidates (1.39 v. 1.37, p = 0.89).

*Conclusions: At our center, there was no significant difference in reasons for decline by the committee when comparing declined Hispanic and non-Hispanic living liver donor candidates. This suggests that the disparity among Hispanics in LDLT occurs elsewhere, such as earlier in the donor evaluation process or could even be related to illness severity of intended recipients. There are ongoing efforts to establish multi-center comprehensive donor candidate registries that may reveal how donor evaluation processes at various centers may influence disparities in particular regions.

To cite this abstract in AMA style:

Toy D, Horwich B, Mulgaonkar A, Padilla A, Dodge JL, Kaur N, Han H. A Qualitative Comparison of Declined Hispanic and Non-Hispanic Living Liver Donor Candidates at a High-Volume Urban Transplant Center [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/a-qualitative-comparison-of-declined-hispanic-and-non-hispanic-living-liver-donor-candidates-at-a-high-volume-urban-transplant-center/. Accessed November 21, 2024.

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