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

Liver Transplant Waitlist Mortality is Not Associated with Urbanicity

Y. Chen1, Y. Hung2, Y. Hsu3, C. de Crescenzo1, C. Rickert1, J. Adler4, D. Chang1, H. Yeh1

1Surgery, Massachusetts General Hospital, Boston, MA, 2Surgery, Sinai Hospital of Baltimore, Baltimore, MA, 3Harvard School of Public Health, Boston, MA, 4Surgery, Brigham and Women's Hospital, Boston, MA

Meeting: 2020 American Transplant Congress

Abstract number: A-250

Keywords: Allocation, Liver transplantation, Outcome, Waiting lists

Session Information

Session Name: Poster Session A: Non-Organ Specific: Disparities to Outcome and Access to Healthcare

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Because of geographic disparity in transplant rates and organ usage, distance-based liver distribution has been proposed to replace Donor Service Area based distribution. However, there is some concern that this policy will disadvantage rural populations when mixed with urban populations in a match run, because issues with access to care could place rural patients at higher risk of death, even at the same MELD score. We therefore aimed to investigate the impact of urbanicity on wait list mortality among liver transplant candidates with similar MELD scores.

*Methods: We included adult transplant candidates who were on the waitlist 2010-2019, using the Scientific Registry of Transplant Recipients (SRTR). Our primary outcome was mortality rates within certain MELD score ranges among patients who did not receive a transplant, comparing urbanicity using zip code of residence, defined by rural-urban continuum codes (RUCC). Multivariate logistic regression was used to adjust for social and medical factors.

*Results: 24,820 patients, 365 (1.5%) living in rural areas, were analyzed (table 1). Compared to patients living in metropolitan areas, rural patients were more likely to be women (41.9% vs 38.9%), be white (85.8% vs 65.8%), US citizens (99.5% vs 94.2%), live >=200 miles away from the listed center (35.6% vs 8.7%), and less likely to be private insurance holders (38.9% vs 51.7%). After adjusting for demographic and medical factors, there were no significant differences in mortality between metro and rural patients with similar severity of illness (table 2).

*Conclusions: We found no difference in mortality rates of wait list candidates not receiving a transplant between rural and urban patients with similar severity of illness. Patients at higher risk due to poor access to care may not even be making it to the wait list. Improving access for rural patients and implementing distance-based liver allocation could have complementary roles in mitigating geographic disparity in access to liver transplantation.

 border=

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Chen Y, Hung Y, Hsu Y, Crescenzo Cde, Rickert C, Adler J, Chang D, Yeh H. Liver Transplant Waitlist Mortality is Not Associated with Urbanicity [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/liver-transplant-waitlist-mortality-is-not-associated-with-urbanicity/. Accessed May 10, 2025.

« Back to 2020 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