A0456 - Liver Transplantation Demographics and Indications Over Two Decades: Single Center Retrospective Analysis

Adnan Khan, DO¹, John Bruckbauer, ², Sarah L. Chen, BA³, Heather M. Ross, BS⁴, Brian M. Yan, BA³, Natalia Salinas Parra, BS⁴, Peter Zhang,², Richard S. Kirby, ⁵, Michelle Schafer, ⁵, Lyena Birkenstock, BA², William Cooley, ², Dina Halegoua-DeMarzio, MD^5
1Thomas Jefferson University Hospital, Ballwin, MO; ²Thomas Jefferson University, Philadelphia, PA; ³Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; ⁴Sidney Kimmel Medical College, Philadelphia, PA; ⁵Thomas Jefferson University Hospital, Philadelphia, PA

Introduction: Liver transplantation (LT) is a therapeutic treatment option for patients with acute liver failure and end stage liver disease. The aim of this study is to evaluate changes in LT indications and patient demographics over two decades.

Methods: Data on demographic information and indications for LT from 2002-2020 were collected from the Thomas Jefferson University transplant database. Demographic factors analyzed were age, race and gender. Indications for LT included non-alcoholic fatty liver disease (NASH/NAFLD), Alcohol Cirrhosis, drug use, viral hepatitis B and C (HBV, HCV), autoimmune cause, primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), hepatocellular carcinoma (HCC), or common combinations of two indicators. Frequencies of demographic factors overall and within transplant indications were calculated. Comparisons between demographic factors were made using chi-square tests (p< 0.05).

Results: Of the 974 patients in our study, 685 were male, and 289 were female. The mean age at the time of LT was 56.0 years ± 10.7 years, and 758 were White 115, Black, 59 Hispanic, 42 Asian, and 9 Other. The most common indications for LT were HCV complicated by HCC (25.9%) and alcoholic cirrhosis (16.0%).

For the entire population, there was no statistically significant relationship between age and race (P=0.051).

Patients with alcoholic cirrhosis + HCC, Hispanics were significantly older than their White and Black counterparts (68.3 years vs 59.9 and 55.8 years, respectively, P=0.044). Men tended to be older at the time of transplant than women (56.54 years vs 54.59 years respectively, p=0.0005). When stratified by indication, male patients with Alcohol Cirrhosis + HCC were significantly older than their female counterparts (60.7 years vs 56.3 years). For our entire group, although White patients received 77.8% of LT, there was no statistically significant relationship between the racial distribution of LT and the gender distribution of LT.

Discussion: Race was not significantly associated with age or gender in indication for LT. After stratifying by indication, we found that Hispanic patients with alcoholic cirrhosis and HCC were significantly older. When stratifying by age, older male patients underwent LT at higher rates than females regardless of indication. Determining to what extent female gender and Hispanic race play a role in transplant indication through studies focusing on potential causes and outcomes is essential to help physicians target and utilize LT resources.



Disclosures:


Adnan Khan, DO¹, John Bruckbauer, ², Sarah L. Chen, BA³, Heather M. Ross, BS⁴, Brian M. Yan, BA³, Natalia Salinas Parra, BS⁴, Peter Zhang,², Richard S. Kirby, ⁵, Michelle Schafer, ⁵, Lyena Birkenstock, BA², William Cooley, ², Dina Halegoua-DeMarzio, MD⁵. A0456 - Liver Transplantation Demographics and Indications Over Two Decades: Single Center Retrospective Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.