A0463 - Investigating Gender Disparities in Liver Transplant Recipients in the United States

Mahmoud Mansour, MD¹, Ratib Mahfouz, MD², Mohammad Darweesh, MD³, Adham E. Obeidat, MBBS⁴, Sanket D. Basida, MD⁵, Ahmad Ali, MD^5
1University of Missouri Columbia, Columbia, MO; ²Brown University/Kent Hospital, Providence, RI; ³East Tennessee State University, Johnson City, TN; ⁴University of Hawaii, Honolulu, HI; ⁵University of Missouri, Columbia, MO

Introduction: Liver transplantation is a lifesaving therapy for patients suffering from end-stage liver disease. Equitable access to liver transplants is of paramount importance. Unfortunately, the gender gap, with females receiving fewer liver transplants, has increased further even after the validation of the Model for End-Stage Liver disease (MELD) in the United States in 2002. This study aims to evaluate the gender gap in liver transplants across different socioeconomic variables.

Methods: We performed analysis of admission data from the Nationwide Inpatient Sample (NIS) between 2016 and 2019. We identified patients who underwent a liver transplant using the International Disease Classification of Disease 10^thProcedure Coding System (ICD-10-PCS). Multivariate logistic regression was used to evaluate the impact of gender on liver transplantation across different demographic groups.

Results: A total of 29,050 heart transplants were performed over the study period, of which 10501 (36.1%) were females. After adjusting for comorbidities, socioeconomic, and demographic factors, White females were less likely to receive a liver transplant compared to White males (adjusted odds ratio [AOR] 0.74, P < 0.001). In contrast, Black and Hispanic females did not have a statistically significant difference in transplant compared to their male counterparts (AOR 1.05, P 0.568 and 0.95, P 0.472; respectively). Additionally, females older than 45 also had lower transplant rates than males of the same age group (AOR 0.77, P < 0.001). Females with Medicare or private insurance also had lower rates of transplant (AOR 0.76, P < 0.001 and 0.77, P < 0.001; respectively), while those with Medicaid did not (1.01, P = 0.854). Across all income quartiles and all geographic distributions, the female gender was independently associated with lower transplant rates.

Discussion: Females who were White, older than 45 years, or had Medicare or Private insurance had lower rates of a liver transplant than their male counterparts. Females also had lower transplant rates regardless of their income or geographic distribution. This study highlights the complex interactions between gender disparities and different socioeconomic variables. Further patient-level research is needed to help understand gender disparities in liver transplants to better advocate for patients suffering from end-stage liver disease.



Disclosures:


Mahmoud Mansour, MD¹, Ratib Mahfouz, MD², Mohammad Darweesh, MD³, Adham E. Obeidat, MBBS⁴, Sanket D. Basida, MD⁵, Ahmad Ali, MD⁵. A0463 - Investigating Gender Disparities in Liver Transplant Recipients in the United States, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.