While liver transplantation was less likely for Black patients with HCC, those who did receive a transplant experienced worse outcomes.
Fnu Vikash, MD
Black patients with hepatocellular carcinoma had lower rates of liver transplantation, as well as more complications and mortality when they did undergo a transplant, than other participants in a study of more than 112,000 patients, according to findings presented at the 2023 ASCO Annual Meeting.
“According to the National Comprehensive Cancer Network, liver transplantation is currently the treatment of choice for patients with early HCC,” Fnu Vikash, MD, and colleagues wrote. “A retrospective study in 2016 showed a difference in mortality among races in patients undergoing treatment for HCC. Our study is the first to compare the outcomes of mortality, morbidity and hospital utilization of HCC patients undergoing [liver transplantation] among races in the US.”
Dr. Vikash and colleagues examined 2016-2020 data from the Nationwide Inpatient Sample and used multivariate regression analysis to compare outcomes across different races, adjusting for patient and hospital confounders. The researchers also compared baseline patient characteristics.
Black & Hispanic Patients Experience Worse Outcomes
The analysis included 112,110 adults with HCC. Among this group, 3,150 had a liver transplantation (2.8%).
Dr. Vikash and colleagues found that Black individuals had lower rates of liver transplantation, and both Black and Hispanic patients had lower income. While they observed no differences in the Charlson Comorbidity Index across races, they did report that there were more smokers among the group of Black patients (P=0.0149). Black patients also experienced greater rates of mortality (P=0.004) and acute kidney injury (P=0.001).
Hispanic patients incurred significantly higher hospital costs than White patients (coefficient: $102,058 [95% CI, $109,404-$119,787]; P=0.033). However, there was no difference reported between races regarding length of stay, and Black patients had similar rates of transplant complications compared with individuals of other races.
“Our study showed that, while Black [patients] have lower rates of [liver transplantation], they have a higher rate of mortality and morbidity following [liver transplantation],” Dr. Vikash and colleagues wrote. “Large-scale studies are necessary to help determine factors associated with these findings.”
