Department of Medicine, Lincoln Medical Center/Weill Cornell Medicine, New York, NY, USA.
Department of Medicine, SIU School of Medicine, Springfield, IL, USA.
Dig Dis Sci. 2023 Oct;68(10):4050-4059. doi: 10.1007/s10620-023-08084-z. Epub 2023 Aug 16.
Previous studies have demonstrated a disparity in liver transplantation (LT) for hepatocellular carcinoma (HCC) among races in the United States (U.S.).
We aimed to update the literature on the odds, trends, and complications of LT in the treatment of hepatocellular carcinoma (HCC), among individuals of different racial backgrounds.
This is a nationwide study of adult individuals admitted for LT with a primary diagnosis of HCC. Using weighted data from the National Inpatient Sample (NIS) database, we compared the odds of LT among different races from 2016 to 2020, using a multivariate regression analysis. We further assessed the trends and outcomes of LT among races.
A total of 112,110 adult were hospitalized with a primary diagnosis of HCC. 3020 underwent LT. When compared to Whites, the likelihood of undergoing LT for HCC was significantly reduced in Blacks (OR = 0.60, 95% CI = 0.46-0.78). Further, Blacks had increased mortality rates (7% in Blacks vs. 1% in Whites, p < 0.001), sepsis (11% in Blacks vs. 3% in Whites, p = 0.015), and acute kidney injury (AKI) (54% in Blacks vs. 31% in Whites, p < 0.001) following LT.
Individuals identifying as Blacks were less likely to undergo LT for HCC, and more likely to develop complications. Further initiatives are warranted to mitigate the existing disparities among racial groups.
先前的研究表明，在美国（U.S.）不同种族之间，肝移植（LT）治疗肝细胞癌（HCC）的比例存在差异。
我们旨在更新有关不同种族背景个体接受 LT 治疗 HCC 的几率、趋势和并发症的文献。
这是一项针对因 HCC 接受 LT 的成年个体的全国性研究。我们使用国家住院患者样本（NIS）数据库的加权数据，通过多变量回归分析，比较了 2016 年至 2020 年不同种族之间接受 LT 的几率。我们进一步评估了不同种族之间 LT 的趋势和结果。
共有 112110 名成年个体因 HCC 接受住院治疗。其中 3020 人接受了 LT。与白人相比，黑人接受 HCC 接受 LT 的几率明显降低（OR=0.60，95%CI=0.46-0.78）。此外，黑人的死亡率更高（黑人 7%，白人 1%，p<0.001），败血症（黑人 11%，白人 3%，p=0.015）和急性肾损伤（AKI）（黑人 54%，白人 31%，p<0.001）的发病率也更高。
自认为是黑人的个体接受 HCC 接受 LT 的可能性较小，发生并发症的可能性更大。需要进一步采取措施来减少不同种族群体之间的现有差距。
