Tincopa Monica, Pace Jordan L, Delebecque Fanny, Torosian Kelly, Arellano Denya, Martinez Maria Elena, Vodkin Irine, Ajmera Veeral
Department of Medicine, Division of Gastroenterology and Hepatology, MASLD Research Center, University of California San Diego, San Diego, CA, United States.
Department of Medicine, School of Medicine, California University of Science and Medicine, Colton, CA, United States.
Front Transplant. 2025 Aug 20;4:1592516. doi: 10.3389/frtra.2025.1592516. eCollection 2025.
Social determinants of health (SDOH) and transplant center characteristics have been associated with access to liver transplantation (LT) for Hispanic individuals. The aim of this study was to identify waitlist characteristics and correlates of odds of LT and waitlist removal by Hispanic ethnicity.
This was a single-center cohort study of adults listed for LT between January 2018-December 2020. Demographic, clinical, and SDOH were analyzed using logistic regression.
375 patients were included. 52.5% ( = 197) were Hispanic. At time of listing, Hispanic patients had significantly higher BMI, prevalence of diabetes and metabolic dysfunction associated steatohepatitis. Rates of substance use were significantly lower and time of last drink to listing was significantly longer (641 vs. 391 days, = 0.0007) in Hispanic adults. Rates of LT and waitlist removal did not significantly differ by Hispanic ethnicity (46.9% vs. 46.1% and 35% vs. 36.5%, respectively). Hepatocellular carcinoma (OR 3.28) was associated with odds of LT whereas employment status predicted waitlist removal.
Distribution on the waitlist, LT and waitlist removal did not differ by Hispanic ethnicity. Hispanic patients had significantly longer time from last drink to listing, suggesting referral bias. Public health interventions to optimize LT referral are needed to increase health equity.
健康的社会决定因素（SDOH）和移植中心特征与西班牙裔个体获得肝移植（LT）的机会有关。本研究的目的是确定等待名单特征以及西班牙裔种族接受LT和从等待名单中移除的几率的相关因素。
这是一项对2018年1月至2020年12月期间列入LT等待名单的成年人进行的单中心队列研究。使用逻辑回归分析人口统计学、临床和SDOH数据。
共纳入375例患者。52.5%（n = 197）为西班牙裔。在列入等待名单时，西班牙裔患者的体重指数、糖尿病患病率和代谢功能障碍相关脂肪性肝炎显著更高。西班牙裔成年人的物质使用率显著更低，从最后一次饮酒到列入等待名单的时间显著更长（641天对391天，P = 0.0007）。西班牙裔种族的LT率和从等待名单中移除的率没有显著差异（分别为46.9%对46.1%和35 %对36.5%）。肝细胞癌（OR 3.28）与接受LT的几率相关，而就业状况可预测从等待名单中移除。
在等待名单上的分布、LT和从等待名单中移除的情况在西班牙裔种族之间没有差异。西班牙裔患者从最后一次饮酒到列入等待名单的时间显著更长，提示存在转诊偏倚。需要采取公共卫生干预措施来优化LT转诊，以提高健康公平性。
