Racial disparity in liver transplantation in an inner city population

Introduction: Multiple studies have identified racial disparity in access to advanced surgical procedures as liver transplantation among African Americans (AA). Our University program has traditionally served the socioeconomically challenged patients of New Orleans. Methods: Retrospective analyses comparing racial presentation and outcomes of all adult liver transplant recipients '07–'15. Statistical analysis was carried out with SAS software. Results: Of 223 recipients 65 were AA (29.1%) which was representative of the general racial makeup of Louisiana. AA were younger than Caucasians (CA) at transplant (55 vs. 57 yrs, p = 0.01) with higher INRs (1.7 vs. 2.0, p = 0.025) but equivalent MELD scores (22 vs. 21, p = 0.113). Post-operative outcomes were similar including vascular complication, reoperation, ventilator days and length of stay. Five-year graft and patient survival were similar (86.2% vs. 81.6%, p = 0.557 and 86.2% vs. 82.9%, p = 0.690). Conclusions: In our inner city institution we identified an equivalent racial access to transplantation to the racial distribution within the State. However we identified that African American patients were significantly younger than their Caucasian counter parts and were more apt to be acutely decompensated as identified by their higher INRs. The five-year graft and patient outcomes were not significantly different. This study confirms that even in our inner city center there appears to be some racial disparity in patient selection. This study warrants a further regional and national evaluation.