{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:11:43Z","timestamp":1747149103057,"version":"3.40.5"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>Racial\/ethnic minorities experience higher rates of wait\u2010list mortality and longer waiting times on the liver transplant wait list. We hypothesized that racial\/ethnic minorities may encounter greater logistical barriers to maintaining \u201creadiness\u201d on the wait list, as reflected in offer nonacceptance. We identified all candidates who received an organ offer between 2009 and 2018 and investigated candidates who did not accept an organ offer using a free\u2010text refusal reason associated with refusal code 801. We isolated patients who did not accept an organ offer due to \u201ccandidate\u2010related logistical reasons\u201d and evaluated their characteristics. We isolated 94,006 \u201cno 801\u201d patients and 677 \u201cwith 801 logistical\u201d patients. Common reasons for offer decline among the 677 were 60% \u201cunable to travel\/distance,\u201d 22% \u201ccannot be contacted,\u201d 13% \u201cnot ready\/unspecified,\u201d and 5% \u201cfinancial\/insurance.\u201d Compared to \u201cno 801,\u201d \u201cwith 801 logistical\u201d patients were more likely to be Hispanic (19% vs. 15%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.01). Multivariate logistic modeling showed Hispanic (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.17\u20101.76, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.01) and multiracial\/other ethnicity (OR 1.82, 95% CI 1.08\u20103.05, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.02) were associated with \u201cwith 801 logistical\u201d status. The \u201cwith 801 logistical\u201d patients were listed with higher allocation (inclusive of exception points) Model for End\u2010Stage Liver Disease scores (16 vs. 15, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.01) and remained longer on the wait list (median 428\u00a0days vs. 187\u00a0days, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.01). <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> In this analysis of wait\u2010list candidates, we isolated 677 patients who declined an organ offer with a free\u2010text reason consistent with a \u201ccandidate\u2010related logistical reason.\u201d Compared with non\u2010Hispanic Whites, Hispanics were at 1.44 odds of not accepting organ offers due to logistical reasons. These limited findings motivate further research into interventions that would improve candidates\u2019 \u201creadiness\u201d to accept organ offers and may benefit racial\/ethnic minorities on the liver\u2010transplantation wait list.<\/jats:p>","DOI":"10.1002\/hep4.1865","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T07:00:02Z","timestamp":1637046002000},"page":"1227-1235","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["An Analysis of Free\u2010Text Refusals as an Indicator of Readiness to Accept Organ Offers in Liver Transplantation"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1574-1525","authenticated-orcid":false,"given":"Jin","family":"Ge","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine,University of California, San Francisco,San Francisco,CA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine","family":"Ku","sequence":"additional","affiliation":[{"name":"Division of Nephrology,Department of Medicine,University of California, San Francisco,San Francisco,CA,USA"},{"name":"Division of Pediatric Nephrology,Department of Pediatrics,University of California, San Francisco,San Francisco,CA,USA"},{"name":"Department of Epidemiology and Biostatistics,University of California, San Francisco,San Francisco,CA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garrett R.","family":"Roll","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,Department of Surgery,University of California, San Francisco,San Francisco,CA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2092-6380","authenticated-orcid":false,"given":"Jennifer C.","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine,University of California, San Francisco,San Francisco,CA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"hep41865-bib-0001-20241115","doi-asserted-by":"crossref","first-page":"2662","DOI":"10.1111\/j.1600-6143.2009.02857.x","article-title":"Race and ethnicity in access to and outcomes of liver transplantation: a critical literature review","volume":"9","year":"2009","journal-title":"Am J Transplant"},{"key":"hep41865-bib-0002-20241115","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1002\/lt.25964","article-title":"A review of the current state of liver transplantation disparities","volume":"27","year":"2021","journal-title":"Liver Transpl"},{"key":"hep41865-bib-0003-20241115","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1002\/lt.22108","article-title":"Racial and ethnic disparities in access to liver 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