Transplant for Liver Cancer: Does Donor Race Impact Survival?

A study published in the Journal of the American College of Surgeons found that black patients with hepatocellular carcinoma (HCC) who underwent liver transplantation had significantly improved overall survival (OS) when the donor was also black.

Researchers used the Organ Procurement and Transplantation Network database to identify 1,384 adult black patients with HCC undergoing liver transplantation between 1994 and 2015. Patients were grouped based on whether the liver donor was also black (matched; n=325; 23.5%) or another race (unmatched; n=1,059; 76.5%).

Patients in the matched cohort had significantly better median OS than the unmatched cohort (135 months vs 78 months; P=0.007). Multivariate analysis revealed an adjusted hazard ratio of 0.66 for race-matched transplantation (95% CI, 0.49-0.88; P=0.004); however, this survival advantage did not emerge until after one year. Matched patients also experienced an improved five-year survival (64.2% vs 56.9%; P=0.019).

Race-matching remained an independent predictor of improved survival after the researchers adjusted for comorbidities and disease characteristics.

“Race-matching should be considered in the process of organ allocation,” the researchers concluded.

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Source: Journal of the American College of Surgeons