{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:20:55Z","timestamp":1777414855224,"version":"3.51.4"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T00:00:00Z","timestamp":1565308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T00:00:00Z","timestamp":1565308800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006975","name":"Indiana Clinical and Translational Sciences Institute","doi-asserted-by":"publisher","award":["KL2TR002530 and UL1TR002529"],"award-info":[{"award-number":["KL2TR002530 and UL1TR002529"]}],"id":[{"id":"10.13039\/100006975","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>Racial and ethnic differences in the presentation and outcomes of patients wait\u2010listed with acute liver failure (ALF) have not been explored. Adult patients with ALF wait\u2010listed for liver transplantation (LT) from 2002 to 2016 were investigated using the United Network for Organ Sharing database. Clinical characteristics and causative etiologies were compared between white, black, Hispanic, and Asian patients with ALF who were wait\u2010listed as status 1. A competing risk analysis was used to explore differences in LT and wait\u2010list removal rates. Kaplan\u2010Meier survival curves were used to explore differences in 1\u2010year posttransplant survival. There were 8208 patients wait\u2010listed with a primary diagnosis of ALF; 4501 were wait\u2010listed as status 1 (55.3% of whites, 64.4% of blacks, 51.6% of Hispanics, 40.7% of Asians; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001). Black patients had higher bilirubin and Model for End\u2010Stage Liver Disease at wait\u2010listing than other groups. White patients were the most likely to have acetaminophen toxicity as a causative etiology, whereas black patients were the most likely to have autoimmune liver disease. Black patients were significantly more likely to undergo LT than white patients (hazard ratio, 1.20; 95% confidence interval, 1.08\u20101.30). There was no difference in wait\u2010list removal because of death or clinical deterioration among racial\/ethnic groups. The 1\u2010year posttransplant survival was lowest in black patients (79.6%) versus white (82.8%), Hispanic (83.9%), and Asian (89.3%) patients (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.02). In conclusion, etiologies of ALF vary by race and ethnicity. Black patients with ALF were more likely to be wait\u2010listed as status 1 and undergo LT than white patients, but they were sicker at presentation. The 1\u2010year posttransplant survival rate was lowest among black patients.<\/jats:p>","DOI":"10.1002\/lt.25594","type":"journal-article","created":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T18:33:27Z","timestamp":1562265207000},"page":"1634-1641","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Black Adult Patients With Acute Liver Failure Are Sicker and More Likely to Undergo Liver Transplantation Than White Patients"],"prefix":"10.1097","volume":"25","author":[{"given":"Lauren","family":"Nephew","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Zia","sequence":"additional","affiliation":[{"name":"Department of Medicine,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan","family":"Ghabril","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Orman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3809-640X","authenticated-orcid":false,"given":"Craig","family":"Lammert","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naga","family":"Chalasani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2019,8,9]]},"reference":[{"key":"lt25594-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1056\/NEJMra1208937","article-title":"Acute liver failure","volume":"369","year":"2013","journal-title":"N Engl J Med"},{"key":"lt25594-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.cgh.2009.05.029","article-title":"Racial and ethnic differences in presentation, etiology, and outcomes of acute liver failure in the United States","volume":"7","year":"2009","journal-title":"Clin Gastroenterol Hepatol"},{"key":"lt25594-bib-0003-20240115","first-page":"1401","article-title":"Acute liver failure: summary of a workshop","volume":"47","year":"2008","journal-title":"Hepatology"},{"key":"lt25594-bib-0004-20240115","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","year":"2008","journal-title":"Hepatology"},{"key":"lt25594-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1093\/cid\/ciw249","article-title":"Race and gender differences in the use of direct acting antiviral agents for hepatitis C virus","volume":"63","year":"2016","journal-title":"Clin Infect Dis"},{"key":"lt25594-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1002\/hep.21580","article-title":"Racial disparities in the management of hospitalized patients with cirrhosis and complications of portal hypertension: a national study","volume":"45","year":"2007","journal-title":"Hepatology"},{"key":"lt25594-bib-0007-20240115","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","year":"2004","journal-title":"Liver Transpl"},{"key":"lt25594-bib-0008-20240115","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","year":"2008","journal-title":"JAMA"},{"key":"lt25594-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1002\/lt.20768","article-title":"Regional sharing for adult status 1 candidates: reduction in waitlist mortality","volume":"12","year":"2006","journal-title":"Liver Transpl"},{"key":"lt25594-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1111\/j.1477-2574.2009.00086.x","article-title":"Aetiology and outcome of acute liver failure","volume":"11","year":"2009","journal-title":"HPB (Oxford)"},{"key":"lt25594-bib-0011-20240115","doi-asserted-by":"crossref","first-page":"947","DOI":"10.7326\/0003-4819-137-12-200212170-00007","article-title":"Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States","volume":"137","year":"2002","journal-title":"Ann Intern Med"},{"key":"lt25594-bib-0012-20240115","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/13651820500465741","article-title":"Liver transplantation for acute hepatic failure","volume":"8","year":"2006","journal-title":"HPB (Oxford)"},{"key":"lt25594-bib-0013-20240115","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.mcna.2008.03.005","article-title":"Acute liver failure including acetaminophen overdose","volume":"92","year":"2008","journal-title":"Med Clin North Am"},{"issue":"pt 2","key":"lt25594-bib-0014-20240115","first-page":"1003","article-title":"Liver transplantation in the United States, 1999\u20102008","volume":"10","year":"2010","journal-title":"Am J Transplant"},{"key":"lt25594-bib-0015-20240115","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1111\/j.1572-0241.2008.01809.x","article-title":"Racial differences in liver transplantation outcomes in the MELD era","volume":"103","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"lt25594-bib-0016-20240115","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1097\/01.tp.0000438634.44461.67","article-title":"Disparities in liver transplantation: the association between donor quality and recipient race\/ethnicity and sex","volume":"97","year":"2014","journal-title":"Transplantation"}],"container-title":["Liver 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