ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Gender Disparities In Cirrhosis: New Findings In A Large Pretransplant Population

N. Mazumder, K. Atiemo, A. Daud, L. Zhao, M. Abecassis, J. Levitsky, D. P. Ladner

Northwestern Memorial Hospital, Chicago, IL

Meeting: 2019 American Transplant Congress

Abstract number: C292

Keywords: Allocation, Liver cirrhosis, Multicenter studies, Resource utilization

Session Information

Session Name: Poster Session C: Liver: MELD, Allocation and Donor Issues (DCD/ECD)

Session Type: Poster Session

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: There is concern that female patients may suffer worse outcomes than their male counterparts while awaiting liver transplant. Studies on this topic often use databases of listed patients which may introduce selection bias. We therefore analyzed a large, city wide sample of pre-referral patients to assess if disparities exist prior to listing.

*Methods: We utilized HealthLNK, a Chicago-wide database that incorporates the de-identified electronic medical records from six major health care institutions. We included adult patients with ICD-9 codes of cirrhosis who were not on Coumadin during the period of January 1, 2006, and December 31, 2012. We linked patient records with the state death registry and classified patients’ death certificates as “liver related”, “non-liver related”, and “non-descript”. “Liver-Related” mortality was used as the primary outcome for survival analysis. Time at risk was defined as time from inclusion to either death or transplant with censoring at the end of the study. Chi-squared tests, t-tests, and Cox regression were used for statistical inference.

*Results: Out of 18,690 patients included, 7,975 (42.6%) were female. Both male and female patients had similar distributions of age, race, insurance status, and non-hepatic comorbidities as measured by the Elixhauser co-morbidity index. The most common etiologies of liver disease in both men and women were related to HCV, NASH, and Alcohol, however women had more cholestatic liver disease (17% vs 6% in men p<0.001). Women were less likely to have decompensated cirrhosis with lower rates of ascites (31% vs 37%, p<0.001), encephalopathy (28% vs 32%, p<0.001), variceal bleeding (7% vs 10%, p<0.001), hepatocellular carcinoma (10% vs 17%, p<0.001) and spontaneous bacterial peritonitis (5% vs 7%, p<0.001). In concordance with the pre-referral nature of the cohort, 4% of patients underwent transplant and 50% of patients had appropriate labs from which a MELD score could be generated. Women had a lower peak-MELD (15.6 vs 17.3, p<0.001) and were less likely to receive transplants (3.2% vs 4.9%, p<0.001). However in univariate survival analysis, female sex conferred a protective effect with a 30% decrease in the hazard of liver related death (HR 0.70 95% CI 0.65—0.75, p<0.001). After adjustment for multiple confounders female sex was still associated with a decrease of 16% in the hazard of liver related death as illustrated in Figure 1.

*Conclusions: In summary, in this pre-referral cohort we found female patients were less likely to receive transplants but overall had a lower rate of liver related mortality.

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Mazumder N, Atiemo K, Daud A, Zhao L, Abecassis M, Levitsky J, Ladner DP. Gender Disparities In Cirrhosis: New Findings In A Large Pretransplant Population [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/gender-disparities-in-cirrhosis-new-findings-in-a-large-pretransplant-population/. Accessed May 9, 2025.

« Back to 2019 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences