Black Americans with cirrhosis -- late-stage liver disease -- are much less likely to receive a liver transplant and more likely to die than white patients, new research reveals.
For the study, researchers at Northwestern Medicine analyzed data from all cirrhosis patients, regardless of transplant eligibility, at seven large liver centers in Chicago.
Compared to white patients, Black patients were four times less likely to receive a liver transplant and about 25% more likely to die, according to the study authors.
The racial differences remained after the researchers accounted for severity of liver disease and complications, other health problems (such as heart disease, kidney disease and cancers) and socioeconomic factors.
Among patients listed for liver transplants, there were no racial differences in patient outcomes, the findings showed.
"The findings underscore broader societal issues of access to health care for our Black patients," senior study author Dr. Daniela Ladner said in a Northwestern news release.
"We need to support our Black community to find the way to optimal care, including offering transplants at the same rate as all other patients," added Ladner, a transplant surgeon and professor of surgery at Northwestern's Feinberg School of Medicine.
The study authors noted that earlier research found no racial disparities among cirrhosis patients, but included only those listed for liver transplant, who account for just 2% of all cirrhosis patients.
The researchers didn't examine the causes of the disparities between Black and white patients, but previous studies have pointed to a combination of structural issues (lack of resources such as medical specialists, pharmacies, transportation, safe housing) and institutional policies and practices that prioritize certain groups over others.
According to study co-lead author Dr. Nikhilesh Mazumder, a transplant hepatology fellow, "The findings from this study should prompt quality initiatives at each of the liver centers in this study to examine what barriers to care are contributing the most to the disparities we found. Further research is needed to verify these results on a national level, so we can address this disparity nationwide."
The findings were published online recently in the journal Hepatology.
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on cirrhosis.
SOURCE: Northwestern University, news release, June 23, 2021