End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada: A cohort study
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...
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ftpubmed:oai:pubmedcentral.nih.gov:8542110 2023-05-15T16:15:01+02:00 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. 2021-10-22 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542110/ http://www.ncbi.nlm.nih.gov/pubmed/34678872 https://doi.org/10.1097/MD.0000000000027436 en eng Lippincott Williams & Wilkins http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542110/ http://www.ncbi.nlm.nih.gov/pubmed/34678872 http://dx.doi.org/10.1097/MD.0000000000027436 Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) CC-BY-NC Medicine (Baltimore) 4500 Text 2021 ftpubmed https://doi.org/10.1097/MD.0000000000027436 2021-10-31T00:51:12Z 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. Text First Nations PubMed Central (PMC) Canada British Columbia ENVELOPE(-125.003,-125.003,54.000,54.000) Medicine 100 42 e27436 |
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4500 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: A cohort study |
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description |
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 |
Text |
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. |
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: A cohort study |
title_short |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada: A cohort study |
title_full |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada: A cohort study |
title_fullStr |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada: A cohort study |
title_full_unstemmed |
End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada: A cohort study |
title_sort |
end stage liver disease etiology & transplantation referral outcomes of major ethnic groups in british columbia, canada: a cohort study |
publisher |
Lippincott Williams & Wilkins |
publishDate |
2021 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542110/ http://www.ncbi.nlm.nih.gov/pubmed/34678872 https://doi.org/10.1097/MD.0000000000027436 |
long_lat |
ENVELOPE(-125.003,-125.003,54.000,54.000) |
geographic |
Canada British Columbia |
geographic_facet |
Canada British Columbia |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
Medicine (Baltimore) |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542110/ http://www.ncbi.nlm.nih.gov/pubmed/34678872 http://dx.doi.org/10.1097/MD.0000000000027436 |
op_rights |
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
op_rightsnorm |
CC-BY-NC |
op_doi |
https://doi.org/10.1097/MD.0000000000027436 |
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Medicine |
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100 |
container_issue |
42 |
container_start_page |
e27436 |
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