{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:21:48Z","timestamp":1789791708482,"version":"4.0.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2010,9,1]],"date-time":"2010-09-01T00:00:00Z","timestamp":1283299200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2010,5,20]],"date-time":"2010-05-20T00:00:00Z","timestamp":1274313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:sec>\n            <jats:title>Abstract<\/jats:title>\n            <jats:p>Access to liver transplantation is reportedly inequitable for racial\/ethnic minorities, but inadequate adjustments for geography and disease progression preclude any meaningful conclusions. We aimed to evaluate the association between candidate race\/ethnicity and liver transplant rates after thorough adjustments for these factors and to determine how uniform racial\/ethnic disparities were across Model for End-Stage Liver Disease (MELD) scores. Chronic end-stage liver disease candidates initially wait-listed between February 28, 2002 and February 27, 2007 were identified from Scientific Registry for Transplant Recipients data. The primary outcome was deceased donor liver transplantation (DDLT); the primary exposure covariate was race\/ethnicity (white, African American, Hispanic, Asian, and other). Cox regression was used to estimate the covariate-adjusted DDLT rates by race\/ethnicity, which were stratified by the donation service area and MELD score. With averaging across all MELD scores, African Americans, Asians, and others had similar adjusted DDLT rates in comparison with whites. However, Hispanics had an 8% lower DDLT rate versus whites [hazard ratio (HR) = 0.92, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.011]. The disparity among Hispanics was concentrated among patients with MELD scores &lt; 20, with HR = 0.84 (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.021) for MELD scores of 6 to 14 and HR = 0.85 (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.009) for MELD scores of 15 to 19. Asians with MELD scores &lt; 15 had a 24% higher DDLT rate with respect to whites (HR = 1.24, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.024). However, Asians with MELD scores of 30 to 40 had a 46% lower DDLT rate (HR = 0.54, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.004). In conclusion, although African Americans did not have significantly different DDLT rates in comparison with similar white candidates, race\/ethnicity-based disparities were prominent among subgroups of Hispanic and Asian candidates. By precluding the survival benefit of liver transplantation, this inequity may lead to excess mortality for minority candidates. Liver Transpl 16:1033-1040, 2010. \u00a9 2010 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.22108","type":"journal-article","created":{"date-parts":[[2010,5,23]],"date-time":"2010-05-23T14:58:52Z","timestamp":1274626732000},"page":"1033-1040","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":94,"title":["Racial and ethnic disparities in access to liver transplantation"],"prefix":"10.1097","volume":"16","author":[{"given":"Amit K.","family":"Mathur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas E.","family":"Schaubel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary K.","family":"Guidinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Merion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-4-20250124","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1002\/hep.22223","article-title":"Racial disparity in liver disease: biological, cultural, or socioeconomic factors.","volume":"47","author":"Nguyen","year":"2008","journal-title":"Hepatology"},{"key":"R3-4-20250124","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1007\/s10620-008-0567-5","article-title":"Access to liver transplantation in the MELD era: role of ethnicity and insurance.","volume":"54","author":"Kemmer","year":"2009","journal-title":"Dig Dis Sci"},{"key":"R4-4-20250124","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1007\/s10620-007-9992-0","article-title":"Ethnic variations in chronic liver diseases.","volume":"53","author":"Kemmer","year":"2008","journal-title":"Dig Dis Sci"},{"key":"R5-4-20250124","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1001\/archinte.167.18.1983","article-title":"Epidemiology of hepatocellular carcinoma in Hispanics in the United States.","volume":"167","author":"El-Serag","year":"2007","journal-title":"Arch Intern Med"},{"key":"R6-4-20250124","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jhep.2005.10.002","article-title":"Treatment and outcomes of treating of hepatocellular carcinoma among Medicare recipients in the United States: a population-based study.","volume":"44","author":"El-Serag","year":"2006","journal-title":"J Hepatol"},{"issue":"suppl 1","key":"R7-4-20250124","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1053\/j.gastro.2004.09.013","article-title":"Hepatocellular carcinoma: recent trends in the United States.","volume":"127","author":"El-Serag","year":"2004","journal-title":"Gastroenterology"},{"key":"R8-4-20250124","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1002\/hep.20554","article-title":"Racial and ethnic distribution of nonalcoholic fatty liver in persons with newly diagnosed chronic liver disease.","volume":"41","author":"Weston","year":"2005","journal-title":"Hepatology"},{"key":"R9-4-20250124","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1002\/lt.20174","article-title":"Disparity in use of orthotopic liver transplantation among blacks and whites.","volume":"10","author":"Reid","year":"2004","journal-title":"Liver Transpl"},{"key":"R10-4-20250124","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1001\/jama.2008.720","article-title":"Disparities in liver transplantation before and after introduction of the MELD score.","volume":"300","author":"Moylan","year":"2008","journal-title":"JAMA"},{"key":"R12-4-20250124","doi-asserted-by":"crossref","first-page":"2470","DOI":"10.1111\/j.1600-6143.2006.01508.x","article-title":"Geographic differences in event rates by Model for End-Stage Liver Disease score.","volume":"6","author":"Roberts","year":"2006","journal-title":"Am J Transplant"},{"key":"R13-4-20250124","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1001\/jama.291.15.1871","article-title":"MELD scores of liver transplant recipients according to size of waiting list: impact of organ allocation and patient outcomes.","volume":"291","author":"Trotter","year":"2004","journal-title":"JAMA"},{"key":"R14-4-20250124","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1056\/NEJM199810293391811","article-title":"Geographic favoritism in liver transplantationunfortunate or unfair?","volume":"339","author":"Ubel","year":"1998","journal-title":"N Engl J Med"},{"key":"R15-4-20250124","doi-asserted-by":"crossref","first-page":"707","DOI":"10.7326\/0003-4819-146-10-200705150-00004","article-title":"Differences in access to liver transplantation: disease severity, waiting time, and transplantation center volume.","volume":"146","author":"Ahmad","year":"2007","journal-title":"Ann Intern Med"},{"key":"R16-4-20250124","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1111\/j.1600-6143.2009.02744.x","article-title":"Geographic variation in organ availability is responsible for disparities in liver transplantation between Hispanics and Caucasians.","volume":"9","author":"Volk","year":"2009","journal-title":"Am J Transplant"},{"key":"R17-4-20250124","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","author":"Mathur","year":"2009","journal-title":"Am J Transplant"},{"issue":"suppl 9","key":"R18-4-20250124","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/j.1600-6135.2004.00403.x","article-title":"Improving liver allocation: MELD and PELD.","volume":"4","author":"Freeman","year":"2004","journal-title":"Am J Transplant"},{"key":"R21-4-20250124","first-page":"56650","article-title":"Health Resources and Services Administration, HHS. Final rule.","volume":"64","year":"1999","journal-title":"Fed Regist"},{"key":"R22-4-20250124","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j.1600-6143.2004.00703.x","article-title":"The survival benefit of liver transplantation.","volume":"5","author":"Merion","year":"2005","journal-title":"Am J Transplant"},{"issue":"pt 2","key":"R23-4-20250124","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/j.1600-6143.2009.02567.x","article-title":"Liver and intestine transplantation in the United States 1998-2007.","volume":"9","author":"Berg","year":"2009","journal-title":"Am J Transplant"},{"key":"R24-4-20250124","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1001\/jama.280.13.1148","article-title":"Barriers to cadaveric renal transplantation among blacks, women, and the poor.","volume":"280","author":"Alexander","year":"1998","journal-title":"JAMA"},{"key":"R25-4-20250124","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1053\/ajkd.2001.21297","article-title":"Why hemodialysis patients fail to complete the transplantation process.","volume":"37","author":"Alexander","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"R26-4-20250124","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1111\/j.1600-6143.2009.02561.x","article-title":"Framing disparities along the continuum of care from chronic kidney disease to transplantation: barriers and interventions.","volume":"9","author":"Ladin","year":"2009","journal-title":"Am J Transplant"},{"key":"R27-4-20250124","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/TP.0b013e31816223f8","article-title":"Impact of geographic location on access to liver transplantation among ethnic minorities.","volume":"85","author":"Kemmer","year":"2008","journal-title":"Transplantation"},{"key":"R28-4-20250124","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s10620-009-0803-7","article-title":"Liver transplantation in the ethnic minority population: challenges and prospects.","volume":"55","author":"Kemmer","year":"2010","journal-title":"Dig Dis Sci"},{"key":"R29-4-20250124","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1007\/s10620-008-0567-5","article-title":"Access to liver transplantation in the MELD era: role of ethnicity and insurance.","volume":"54","author":"Kemmer","year":"2009","journal-title":"Dig Dis Sci"},{"issue":"pt 2","key":"R30-4-20250124","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1111\/j.1600-6143.2009.02571.x","article-title":"Survival benefit-based deceased donor liver allocation.","volume":"9","author":"Schaubel","year":"2009","journal-title":"Am J Transplant"},{"key":"R31-4-20250124","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/s10620-007-9872-7","article-title":"Ethnic differences in hepatocellular carcinoma: implications for liver transplantation.","volume":"53","author":"Kemmer","year":"2008","journal-title":"Dig Dis Sci"},{"key":"R32-4-20250124","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.1001\/jama.2008.732","article-title":"Race and sex disparities in liver transplantation: progress toward achieving equal access?","volume":"300","author":"Axelrod","year":"2008","journal-title":"JAMA"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.22108","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.22108","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201009000-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T17:04:48Z","timestamp":1737738288000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201009000-00004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,9]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2010]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.22108","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2010,9]]}}}