Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
The US performs over 7,000 liver transplants per year and a substantial subset of Non-US citizen recipients exist. United Network for Organ Sharing (UNOS) policy clearly defines “transplant tourism" and states that the non-resident recipients should not exceed 5% of the total number of transplants of any organ. Although not previously studied, organ shortage makes it imperative that Non-US citizen LTR are critically analyzed and compared to US LTR.
We retrospectively analyzed 50,422 LTR from 1992-2015 using the (OPTN). Using Multivariate Cox Regression and Kaplan-Meier (KM) methodology, we evaluated the association between US/Non-US citizenship and survival.
Significant predictors of survival included US citizenship (p<.001), and other co-variates of interest.
|HR w/ CI||p=|
|Non-US Citizen||0.78 (0.68-0.89)||.0001|
|Race (white as reference) Black||1.32 (1.24-1.40)||.0001|
|Graft Cold Ischiemia Time||1.01 (1.00-1.01)||.02|
|Age of Donor||1.01 (1.02-1.01)||.0001|
|Male Gender||1.10 (1.06-1.15)||.0001|
|+HCV in Recipient||1.49 (1.44-1.56)||.0001|
|Recipient Length of Stay||1.01 (1.01-.1.01)||.0001|
|Donor BMI||0.99 (0.99-1.00)||.31|
|Recipient MELD||0.99 (0.99-0.99)||.0001|
|PVT in Recipient||1.15 (1.04-1.27)||.01|
|Rejection in 1st Year post Transplant||1.29 (1.23-1.36)||.0001|
|Any Known Recipient Malignancy||1.18 (1.09-1.28)||.0001|
|Previous Transplant in Recipient||1.23 (1.14-1.32)||.0001|
|Dialysis Pre-Transplnat in Recipient||1.18 (1.10-1.27)||.0001|
|Mode of Payment (any insurence as reference) Cash||0.72 (0.53-0.97)||.03|
|Foreign Government||1.07 (0.64-1.79)||.80|
Non-US citizens have a 22% increase in patient survival when compared to US citizen recipients over time. (LogRank of KM curve p<.001)
Non-US citizen LTR show superior graft and patient survival when compared to US citizen recipients. We feel superior outcomes in Non-US liver recipients justify the current UNOS policy on transplanting these patients.
CITATION INFORMATION: Butler T., Rana A., Garfinkel M. Non-US Citizen Liver Transplant Recipients (LTR) Have Superior Outcomes Compared to US Citizen LTR: A Retrospective Study of 50,422 Subjects Using the Organ Procurement and Transplant Network (OPTN) from 1992-2015 Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Butler T, Rana A, Garfinkel M. Non-US Citizen Liver Transplant Recipients (LTR) Have Superior Outcomes Compared to US Citizen LTR: A Retrospective Study of 50,422 Subjects Using the Organ Procurement and Transplant Network (OPTN) from 1992-2015 [abstract]. https://atcmeetingabstracts.com/abstract/non-us-citizen-liver-transplant-recipients-ltr-have-superior-outcomes-compared-to-us-citizen-ltr-a-retrospective-study-of-50422-subjects-using-the-organ-procurement-and-transplant-network-optn-f/. Accessed August 9, 2020.
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