Women, Ethnic Groups Wait Longer For Liver Transplantation

March 05, 1998

A study of the factors that influence how long a person who needs a liver transplant has to wait has shown that women, Hispanic-Americans, Asian-Americans, and children waited longer than other groups for transplants. Conversely, Foreign nationals and repeat transplant patients waited the least amount of time. Although the data also showed that groups with longer waiting times are at risk of dying, this was not true for children. The study, published in the March 5, 1998 issue of Medical Care, also showed that foreign nationals received a disproportionate number of transplants at several transplant centers.

Lead author Ann Klassen, PhD, instructor, Health Policy and Management, Johns Hopkins School of Public Health said, "Although it is difficult from theses data to tell why some groups wait longer than other, these patterns show a trend of possible disadvantage among several minority patient groups. That this is a cause for concern."

Dr. Klassen's study looked at 7,422 records from the United Network for Organ Sharing(UNOS)/ Organ Procurement Transplant Network(OPTN) liver waiting lists and transplant recipient list over a 27 month period from 1990 through 1992. Her group found that women waited 110 days to receive a liver. That is 19 days longer than men. Foreign national waited 61 days for a liver transplant while Asian-Americans and Hispanic-Americans waited 138 and 107 days respectively. Native and African-American patients did not wait significantly longer than Caucasian-American patients. Both pre-school and school age children waited three weeks longer to receive liver transplants than adults. This may be due to the fact that children need smaller organs.

The study also found that the number of people on the local waiting list and the transplant to procurement ratio for local organ procurement organizations had a significant effect on waiting time.

Liver transplants are the second most common type of transplant in the United States and account for 20% of all transplants performed. They are also the most expensive solid organ transplant with a median cost of about $186,000 in 1992. In 1990, private insurance paid for 78% of liver transplants.

A number of factors limit access to liver transplants. These include cost of treatment and payment; availability and capacity of transplant programs; supply and distribution of donor organs; and criteria for patient acceptance into a donor program.

Johns Hopkins University Bloomberg School of Public Health

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