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Study concludes no racial disparities in long-term outcomes in recipients of liver transplants
May 20, 2008New research published in the Journal of the American College of Surgeons shows long-term survival and liver rejection rates are equivalent for African-American liver transplant patients as compared with patients of other races. The study also suggests that although other factors such as liver cancer or hepatitis may negatively influence long-term survival, race does not.
Racial disparities in incidence, severity, methods of treatment and access to care have previously been shown in a variety of diseases, including liver disease. African-American patients appear to be underrepresented among liver transplantation recipients. In 2005, for instance, only 6.8 percent of all patients in the United Network for Organ Sharing database and 9.4 percent of liver transplant recipients were African American, compared with the general population of the United States, in which African Americans represented 12.9 percent of the total.
"Survival rates after liver transplantation have been shown to be influenced by race, but earlier data on this subject has been conflicting and may not reflect current management of liver transplant recipients," says Dr. Johnny C. Hong, assistant professor of surgery, Department of Surgery and Liver and Pancreas Transplantation at the University of California, Los Angeles Medical Center in Los Angeles, California. "Although our study is the first to find equivalent long-term outcomes among racial groups after liver transplantation, access to care for all patients with end-stage liver disease clearly remains a major goal for all transplant centers. Like many diseases, our patients are best served with early involvement of a multidisciplinary team."
Liver transplantation is required for patients with severe (end-stage) liver disease. People who have liver transplants require close monitoring after their operation and must take drugs that prevent rejection of the transplanted organ (immunosuppressants) for the rest of their lives.
Using information from the UCLA transplant database, researchers reviewed 2,728 patients who underwent primary liver transplantation at the Dumont-UCLA Transplant Center from 1984 to 2007. Among these patients, 57 percent were Caucasian, 28 percent were Hispanic, 11 percent were Asian and 4 percent were African American.
Results were analyzed during two time periods correlating to the primary immunosuppressant drug used during that era (cyclosporine from 1984-1993 and tacrolimus from 1994-2007). The use of the modern immunosuppressant drug tacrolimus substantially reduced the risk of acute rejection, graft loss and patient death compared with cyclosporine and resulted in a marked improvement of patient and graft survival outcomes in African-American patients after liver transplantation. Statistically significant independent predictors of diminished survival in liver transplant patients were older age ( > 55 years), cryptogenic cirrhosis (scarring of the liver), liver cancer and hepatitis C cirrhosis. Race was not found to be a predictor of survival.
Weber Shandwick Worldwide
Liver transplantation is required for patients with severe (end-stage) liver disease. People who have liver transplants require close monitoring after their operation and must take drugs that prevent rejection of the transplanted organ (immunosuppressants) for the rest of their lives.
Using information from the UCLA transplant database, researchers reviewed 2,728 patients who underwent primary liver transplantation at the Dumont-UCLA Transplant Center from 1984 to 2007. Among these patients, 57 percent were Caucasian, 28 percent were Hispanic, 11 percent were Asian and 4 percent were African American.
Results were analyzed during two time periods correlating to the primary immunosuppressant drug used during that era (cyclosporine from 1984-1993 and tacrolimus from 1994-2007). The use of the modern immunosuppressant drug tacrolimus substantially reduced the risk of acute rejection, graft loss and patient death compared with cyclosporine and resulted in a marked improvement of patient and graft survival outcomes in African-American patients after liver transplantation. Statistically significant independent predictors of diminished survival in liver transplant patients were older age ( > 55 years), cryptogenic cirrhosis (scarring of the liver), liver cancer and hepatitis C cirrhosis. Race was not found to be a predictor of survival.
Weber Shandwick Worldwide
Liver Transplantation Current Events and Liver Transplantation News RSSThe use of stem cells in regenerative medicine may also be detrimental for health
The use of stem cells in regenerative medicine is not always beneficial for human health, it may even be harmful according to a work done by the University of Granada and University of León. Scientists have demonstrated that transplantation of human mononuclear cells isolated from umbilical cord blood exerted a deleterious effect in rats with liver cirrhosis.
UF scientists discover new explanation for controversial old patient-care technique
You might not know what it's called, but if you've had general anesthesia before surgery, especially after an accident, it is likely you have received Sellick's maneuver.
How to identify early graft dysfunction preoperatively?
Small-for-size graft dysfunction (SFSGD) following living-related liver transplantation (LRLT) is characterized by early graft dysfunction (EGD) when the graft-to-recipient body weight ratio (GRBWR) is below 0.8%.
Medication effective for acute liver failure in early stages of disease
The antidote for acute liver failure caused by acetaminophen poisoning also can treat acute liver failure due to most other causes if given before severe injury occurs, UT Southwestern Medical Center researchers and their colleagues at 21 other institutions have found.
Prompt diagnosis of ear infections can improve outcome for organ transplant recipients
Organ transplant recipients benefit significantly when they are monitored and receive prompt diagnosis and treatment for otitis media, a common inner ear infection.
Evaluation of standard liver volume formula for Chinese adults
Living donor liver transplantation (LDLT) has been used to alleviate the shortage of available liver donors. Accurate estimation of the standard liver volume (SLV) of the living donor and recipient is crucial.
Women, blacks, Medicare recipients less likely to be evaluated for liver transplantation
Patient race, gender and insurance status influence decisions about who will go on to receive liver transplants, according to a University of Pittsburgh School of Medicine study.
Lower tacrolimus doses is suitable for living donor liver transplantation with small-for-size graft
Several studies have shown that living donor liver transplant (LDLT) recipients required smaller doses of tacrolimus compared with deceased donor liver transplant (DDLT) patients, which indicated that liver regeneration could affect the metabolism of tacrolimus in LDLT.
Sequential TACE and cryosurgery can improve survival times for patients with HCC?
Hepatocellular carcinoma (HCC)--a liver cancer--is recognized as one of the most common cancers in the world that disproportionately affects Southeast Asians and Africans.
Metabolic bone disease in cirrhosis patients
Long-standing liver disease has long been recognized to result in fragile bones with increased risk of fractures. In various international studies, the overall incidence has varied from 11% to 48%, with a fracture rate of 3%-44%.
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