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Friday, 25 January, 2002, 12:11 GMT
'Race role in liver transplants'
liver transplant surgery
Liver transplants over an eight-year period were studied
An American study has found that race could be a key factor in a patient's chances of surviving a liver transplant.

The study, published in The Lancet on Friday, found that African Americans and Asians did not fare as well as white Americans and Hispanic patients.

And the study suggests that the rate of graft failure - due to organ rejection - was nearly twice as high among African Americans

But the study has not yet been able to pinpoint the reasons for the difference in recovery rates.

Chronic organ rejection

The investigators, from the Johns Hopkins University in Baltimore collected data for all liver transplants between 1988 and 1996 in the US.

Collected from the United Network of Organ Sharing, the information included details of the patient's age, sex, race, blood group and cause of death.

Our study suggests there is a clear need for prospective studies to examine our observations further

Dr Paul Thuluvath

It found African Americans had graft failure, due to chronic organ rejection, twice as much as other races.

Also that a two-year graft survival was "significantly lower" among African Americans - 68% compared with 74% for white Americans.

Asians also fared less well, with 64% having a two-year graft survival, whereas Hispanics had a 72% chance.

'Poor compliance'

Similar statistics were found for the patients' five-year survival, which were also low for African American (by 17%) and Asian patients.

Paul Thuluvath, who conducted the study with colleagues from the Baltimore university, said: "Our study suggests there is a clear need for prospective studies to examine our observations further.

"Until then, the reasons for poor survival in African Americans will remain speculative and will probably be dismissed as being due to poor compliance with therapy."

He suggests that there should be more thorough drug trials among African Americans to look at why chronic rejection is higher for this sector of the population.

Cause of death was available for 2,762 patients, with infection being the leading cause, followed by cardiovascular disease.

Malignancy was the second more common cause of death among Asian patients.

The two-year survival for hepatitis C was also lower for African Americans, although the rate for hepatitis B was similar for this race, white Americans and Hispanics.

Bad match

As far as graft survival was concerned, the mean graft survival for African Americans was 300 days less than for White Americans and Hispanics.

In these cases graft loss was put down to rejection, primary non-function, recurrent disease, vascular complication or patient death.

A number of factors were suggested for the lower survival rate among African Americans - a poor donor match, graft loss, poor socio-economic condition and inadequate compliance with therapy.

But the report concludes that none of the above factors were enough to warrant the statistics and that more rigorous drug trials should be undertaken.

See also:

18 Oct 00 | Health
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