Race and Sex Disparities in Liver Transplantation
Progress Toward Achieving Equal Access?
- David A. Axelrod, MD, MBA;
- Elizabeth A. Pomfret, MD, PhD
- Author Affiliations: Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (Dr Axelrod); and Department of Transplantation, Division of Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts (Dr Pomfret).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- AFRICAN AMERICANS
- BLACKS
- HEALTHCARE DISPARITIES
- HEALTH SERVICES ACCESSIBILITY
- LIVER TRANSPLANTATION
- RACE
- RESOURCE ALLOCATION
- SEX FACTORS
- WOMEN'S HEALTH
Unique among medical specialties, the organ transplantation community has the obligation to explicitly allocate a very limited lifesaving resource. Liver transplantation offers the sole hope for long-term survival for patients with end-stage liver disease. Overall survival rates for transplantation now routinely exceed 90% at 1 year, even among patients with the most advanced liver failure, the majority of whom would die within months without a transplant.1,2 As stewards of a precious resource, the transplant community has a goal of achieving an equitable, transparent, and efficient system of organ allocation. Meeting these goals is crucial for maintaining confidence in the transplant system and encouraging organ donation.
Before 2002, deceased donor liver allografts were allocated by using a system that was loosely based on severity of illness and time spent waiting. Review of the national outcomes demonstrated that this system consistently failed to achieve the goals of equity, transparency, …
