MedStar Washington Hospital Center Washington, District of Columbia
Award: Presidential Poster Award
Nuval Cherian, MD1, Esha Parikh, DO2 1MedStar Washington Hospital Center, Washington, DC; 2MedStar Georgetown University Hospital, Washington, DC
Introduction: Primary sclerosing cholangitis (PSC) was formerly thought to primarily affect those of White race. However, a growing body of research has described the disease in patients of other races. In 2010, Bowlus et al described racial differences of PSC suggesting a more severe course in Black patients. Recent studies have continued to describe more severe pre and post-transplant courses among Black patients as well. The reason for these differences is still not understood and much of the study of PSC remains in predominantly White cohorts. Here we will compare patient and disease characteristics based on race among patients receiving transplant from 2012 through 2021.
Methods: A dataset was provided by the UNOS data team for all patients receiving liver transplantation from January 2012-December 2021. Data included information on demographics, disease characteristics, and comorbidities. A chi-squared test was used for categorical data and a Mann-Whitney U test was used for continuous data using R Studio. We compared Black, Hispanic, and Asian patients to White patients individually.
Results: A total of 2741 patients were included in the analysis; 2041 White patients, 470 Black patients, 150 Hispanic patients, and 60 Asian patients. Twenty patients were of other race or Multiracial and excluded from this analysis. Compared to White patients, Black patients were younger at time of transplant, had higher MELD, had lower rates of concurrent bowel disease, higher rates of concurrent autoimmune hepatitis, and higher rates of Hepatitis B core antibody positivity. Compared to white patients, Hispanic patients also had younger age at transplant, higher MELD at listing, and less concurrent IBD. Asian patients had increased MELD at transplant, and increased rates of Hepatitis B surface antigen positivity at time of listing.
Discussion: Several differences were seen in this cohort based on patient race. The findings here, especially with regards to differences between Black and White patients, are consistent with prior studies. These findings also suggest a higher burden of hepatologic comorbidities among Black patients compared to White patients. The data also suggest clinical differences between White and Hispanic patients with regards of comorbid illness and clinical characteristics. Continued exploration of these differences is needed as patients of non-White race may have unique patient care needs not fully explored in the current literature.
Nuval Cherian indicated no relevant financial relationships.
Esha Parikh indicated no relevant financial relationships.
Nuval Cherian, MD1, Esha Parikh, DO2. P2389 - Characteristics of Patients With PSC Undergoing Liver Transplantation Based on Patient Race, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.