Black patients with cirrhosis more likely to die, less likely to get liver transplant

(Press-News.org) Previous research was falsely reassuring; captured only 2% of cirrhosis patients Findings underscore lack of access to health care for Black patients Cirrhosis is leading cause of death and affects more than 600,000 people in U.S.

CHICAGO --- Black patients with cirrhosis - late-stage liver disease - are about 25% more likely to die compared to non-Hispanic white patients and four times less likely to receive a liver transplant, reports a new Northwestern Medicine study.

Estimates of racial disparity in cirrhosis have been limited by a lack of large-scale longitudinal data, which track patients from diagnosis to death and/or transplant.

The paper is one of the first to link all seven large liver centers in Chicago with the death registry and transplant registry to examine racial disparities in cirrhosis on a population level. Previous surveillance of outcomes by race has been through the transplant registry alone, which only captures about 2% of those with cirrhosis, and therefore does not lend itself to understand the true disparity affecting patients with cirrhosis.

"The findings underscore broader societal issues of access to health care for our Black patients," said senior study author Dr. Daniela Ladner, professor of surgery at Northwestern University Feinberg School of Medicine and a Northwestern Medicine transplant surgeon. "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."

The study did not examine the cause of the disparity, but other research has shown the reasons are a combination of structural (lack of resources such as medical specialists, pharmacies, transportation, safe housing) and institutional (policies and practices that disadvantage or prioritize certain groups over others).

The paper was published recently in Hepatology.

Cirrhosis is a common disease thought to affect more than 600,000 people in the U.S. and is a leading cause of death in adults. It is caused by chronic viral infections of the liver (hepatitis B and hepatitis c), fatty liver disease and alcohol use disorder.

Previous research has addressed the small group of patients who are listed for liver transplant ( END