End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada
Abstract Liver disease etiology and transplantation outcomes may vary by ethnicity. We aimed to determine if disparities exist in our province. We reviewed the provincial database for liver transplant referrals. We stratified cohorts by ethnicity and analyzed disease etiology and outcomes. Four thou...
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Ovid Technologies (Wolters Kluwer Health)
2021
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Online Access: | http://dx.doi.org/10.1097/md.0000000000027436 https://journals.lww.com/10.1097/MD.0000000000027436 |
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crovidcr:10.1097/md.0000000000027436 2024-06-23T07:52:48+00:00 End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada A cohort study Chahal, Daljeet Marquez, Vladimir Hussaini, Trana Kim, Peter Chung, Stephen W. Segedi, Maja Chartier-Plante, Stephanie Scudamore, Charles H. Erb, Siegfried R. Salh, Baljinder Yoshida, Eric M. 2021 http://dx.doi.org/10.1097/md.0000000000027436 https://journals.lww.com/10.1097/MD.0000000000027436 en eng Ovid Technologies (Wolters Kluwer Health) http://creativecommons.org/licenses/by-nc/4.0 Medicine volume 100, issue 42, page e27436 ISSN 0025-7974 1536-5964 journal-article 2021 crovidcr https://doi.org/10.1097/md.0000000000027436 2024-05-30T08:21:41Z Abstract Liver disease etiology and transplantation outcomes may vary by ethnicity. We aimed to determine if disparities exist in our province. We reviewed the provincial database for liver transplant referrals. We stratified cohorts by ethnicity and analyzed disease etiology and outcomes. Four thousand nine hundred sixteen referrals included 220 South Asians, 413 Asians, 235 First Nations (Indigenous), and 2725 Caucasians. Predominant etiologies by ethnicity included alcohol (27.4%) and primary sclerosing cholangitis (PSC) (8.8%) in South Asians, hepatitis B (45.5%) and malignancy (13.9%) in Asians, primary biliary cholangitis (PBC) (33.2%) and autoimmune hepatitis (AIH) (10.8%) in First Nations, and hepatitis C (35.9%) in Caucasians. First Nations had lowest rate of transplantation (30.6%, P = .01) and highest rate of waitlist death (10.6%, P = .03). Median time from referral to transplantation (268 days) did not differ between ethnicities ( P = .47). Likelihood of transplantation increased with lower body mass index (BMI) (hazard ratio [HR] 0.99, P = .03), higher model for end stage liver disease (MELD) (HR 1.02, P < .01), or fulminant liver failure (HR 9.47, P < .01). Median time from referral to ineligibility status was 170 days, and shorter time was associated with increased MELD (HR 1.01, P < .01), increased age (HR 1.01, P < .01), fulminant liver failure (HR 2.56, P < .01) or South Asian ethnicity (HR 2.54, P < .01). Competing risks analysis revealed no differences in time to transplant ( P = .66) or time to ineligibility ( P = .91) but confirmed increased waitlist death for First Nations ( P = .04). We have noted emerging trends such as alcohol related liver disease and PSC in South Asians. First Nations have increased autoimmune liver disease, lower transplantation rates and higher waitlist deaths. These data have significance for designing ethnicity specific interventions. Article in Journal/Newspaper First Nations Ovid British Columbia ENVELOPE(-125.003,-125.003,54.000,54.000) Canada Medicine 100 42 e27436 |
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Abstract Liver disease etiology and transplantation outcomes may vary by ethnicity. We aimed to determine if disparities exist in our province. We reviewed the provincial database for liver transplant referrals. We stratified cohorts by ethnicity and analyzed disease etiology and outcomes. Four thousand nine hundred sixteen referrals included 220 South Asians, 413 Asians, 235 First Nations (Indigenous), and 2725 Caucasians. Predominant etiologies by ethnicity included alcohol (27.4%) and primary sclerosing cholangitis (PSC) (8.8%) in South Asians, hepatitis B (45.5%) and malignancy (13.9%) in Asians, primary biliary cholangitis (PBC) (33.2%) and autoimmune hepatitis (AIH) (10.8%) in First Nations, and hepatitis C (35.9%) in Caucasians. First Nations had lowest rate of transplantation (30.6%, P = .01) and highest rate of waitlist death (10.6%, P = .03). Median time from referral to transplantation (268 days) did not differ between ethnicities ( P = .47). Likelihood of transplantation increased with lower body mass index (BMI) (hazard ratio [HR] 0.99, P = .03), higher model for end stage liver disease (MELD) (HR 1.02, P < .01), or fulminant liver failure (HR 9.47, P < .01). Median time from referral to ineligibility status was 170 days, and shorter time was associated with increased MELD (HR 1.01, P < .01), increased age (HR 1.01, P < .01), fulminant liver failure (HR 2.56, P < .01) or South Asian ethnicity (HR 2.54, P < .01). Competing risks analysis revealed no differences in time to transplant ( P = .66) or time to ineligibility ( P = .91) but confirmed increased waitlist death for First Nations ( P = .04). We have noted emerging trends such as alcohol related liver disease and PSC in South Asians. First Nations have increased autoimmune liver disease, lower transplantation rates and higher waitlist deaths. These data have significance for designing ethnicity specific interventions. |
format |
Article in Journal/Newspaper |
author |
Chahal, Daljeet Marquez, Vladimir Hussaini, Trana Kim, Peter Chung, Stephen W. Segedi, Maja Chartier-Plante, Stephanie Scudamore, Charles H. Erb, Siegfried R. Salh, Baljinder Yoshida, Eric M. |
spellingShingle |
Chahal, Daljeet Marquez, Vladimir Hussaini, Trana Kim, Peter Chung, Stephen W. Segedi, Maja Chartier-Plante, Stephanie Scudamore, Charles H. Erb, Siegfried R. Salh, Baljinder Yoshida, Eric M. End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada |
author_facet |
Chahal, Daljeet Marquez, Vladimir Hussaini, Trana Kim, Peter Chung, Stephen W. Segedi, Maja Chartier-Plante, Stephanie Scudamore, Charles H. Erb, Siegfried R. Salh, Baljinder Yoshida, Eric M. |
author_sort |
Chahal, Daljeet |
title |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada |
title_short |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada |
title_full |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada |
title_fullStr |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada |
title_full_unstemmed |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada |
title_sort |
end stage liver disease etiology & transplantation referral outcomes of major ethnic groups in british columbia, canada |
publisher |
Ovid Technologies (Wolters Kluwer Health) |
publishDate |
2021 |
url |
http://dx.doi.org/10.1097/md.0000000000027436 https://journals.lww.com/10.1097/MD.0000000000027436 |
long_lat |
ENVELOPE(-125.003,-125.003,54.000,54.000) |
geographic |
British Columbia Canada |
geographic_facet |
British Columbia Canada |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
Medicine volume 100, issue 42, page e27436 ISSN 0025-7974 1536-5964 |
op_rights |
http://creativecommons.org/licenses/by-nc/4.0 |
op_doi |
https://doi.org/10.1097/md.0000000000027436 |
container_title |
Medicine |
container_volume |
100 |
container_issue |
42 |
container_start_page |
e27436 |
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1802644200084209664 |