Pediatric Liver Transplant Outcomes: Racial, Socioeconomic Disparities

Rachel Patzer, PhD, MPH Assistant Professor Emory University School of Medicine Department of Surgery, Division of Interview with:
Rachel Patzer, PhD, MPH
Assistant Professor
Emory University School of Medicine
Department of Surgery, Division of Transplantation What are the main findings of the study?

Dr. Patzer: We found significant racial/ethnic differences in important health outcomes among pediatric and adolescent patients who received a liver transplantation at a large transplant center in the Southeastern U.S., where rates of mortality and graft failure were higher among minorities compared to white patients. Were any of the findings unexpected?

Dr. Patzer: We expected that poverty would play a role in poor health outcomes for patients, which we did find in this study.  Poverty explained some of the racial disparities we observed.  However, we found that even after accounting for differences in poverty among patients, we still found racial differences in outcomes.  For example, we observed racial disparities even among patients who were wealthier or had better access to care.  It is unclear why these racial/ethnic differences persist. What should clinicians and patients take away from your report?

Dr. Patzer:We hope that clinicians recognize that identifying patients who are at high risk for poor health outcomes, including mortality and graft failure, is important in ensuring equitable and quality healthcare.  Identifying patients who are at higher risk will allow for closer monitoring of these patients to prevent poor health outcomes. What recommendations do you have for future research as a result of this study?

Dr. Patzer: The results of our study were from one large transplant center in the Southeast.  It is unclear whether these disparities exist on a national level, but we expect that there is likely to be regional variation in disparities in outcomes among pediatric liver transplant recipients.  We hope to examine this question using national data.  In addition, more research is needed to identify the potential causes of racial/ethnic differences in outcomes, even after accounting for differences in poverty.


Racial and Socioeconomic Disparities in Pediatric and Young Adult Liver Transplant Outcomes

Thammana RV, Knechtle SJ, Romero R, Heffron TG, Daniels CT, Patzer RE.

Emory University School of Medicine, Atlanta, GA; Rollins School of Public Health, Department of Epidemiology, Atlanta, GA.
Liver Transpl. 2013 Oct 17. doi: 10.1002/lt.23769. [Epub ahead of print]

Last Updated on August 23, 2014 by Marie Benz MD FAAD