HCC: survival higher with race-matched liver transplant

  • Silva JP & al.
  • J Am Coll Surg
  • 2 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • African-American patients receiving liver transplants for early hepatocellular carcinoma (HCC) had better survival when they received a liver from an African-American donor.

Why this matters

  • African-Americans have worse HCC survival than other populations. Most research has focused on recipient characteristics to explain this differential.
  • Donor-recipient race mismatch has been linked to worse survival in lung, kidney, and heart transplant patients.

Study design

  • Analysis of liver transplantation records from the United Network for Organ Sharing Organ Procurement and Transplant Network database from 1994 to 2015 (n=1384 African-American recipients).
  • Funding: None disclosed.

Key results

  • 23.5% of recipients were race-matched.
  • Median OS, race-matched vs non-race-matched (135.0 vs 77.9 months; P=.007).
  • 5-year OS, race-matched vs non-race-matched (64.2% vs 56.9%; P=.019).
  • Race-matched transplantation was associated with improved OS (HR, 0.66; P=.004).
  • Caucasian donor race was a negative predictor of survival compared with African-American donor race (HR, 1.53; P=.004).
  • Hispanic donor race and Asian donor race were trended toward being a negative predictor of survival, but did not reach statistical significance.

Limitations

  • Retrospective study.

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