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Comparative Study
. 2009 Sep;15(9):1010-20.
doi: 10.1002/lt.21759.

Liver transplantation outcomes among Caucasians, Asian Americans, and African Americans with hepatitis B

Natalie Bzowej  1 , Steven Han, Bulent Degertekin, Emmet B Keeffe, Sukru Emre, Robert Brown, Rajender Reddy, Anna S Lok; National Institutes of Health Hepatitis B Virus Orthotopic Liver Transplantation Study Group
Collaborators, Affiliations
Comparative Study

Liver transplantation outcomes among Caucasians, Asian Americans, and African Americans with hepatitis B

Natalie Bzowej et al. Liver Transpl. 2009 Sep.

Abstract

Several previous studies found that Asians transplanted for hepatitis B virus (HBV) infection had worse post-transplant outcomes than Caucasians. Data on post-transplant outcomes of African Americans and waitlist outcomes of Asian Americans and African Americans with hepatitis B are scant. The aim of this study was to compare waitlist and post-transplant outcomes among Asian Americans, African Americans, and Caucasians who had HBV-related liver disease. Data from a retrospective-prospective study on liver transplantation for HBV infection were analyzed. A total of 274 patients (116 Caucasians, 135 Asians, and 23 African Americans) from 15 centers in the United States were enrolled. African Americans were younger and more Asian Americans had hepatocellular carcinoma (HCC) at the time of liver transplant listing. The probability of undergoing transplantation and the probability of survival on the waitlist were comparable in the 3 racial groups. Of the 170 patients transplanted, 19 died during a median follow-up of 31 months. The probability of post-transplant survival at 5 years was 94% for African Americans, 85% for Asian Americans, and 89% for Caucasians (P = 0.93). HCC recurrence was the only predictor of post-transplant survival, and recurrence rates were similar in the 3 racial groups. Caucasians had a higher rate of HBV recurrence: 4-year recurrence was 19% versus 7% and 6% for Asian Americans and African Americans, respectively (P = 0.043). In conclusion, we found similar waitlist and post-transplant outcomes among Caucasians, Asian Americans, and African Americans with hepatitis B. Our finding of a higher rate of HBV recurrence among Caucasians needs to be validated in other studies.

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Figures

Figure 1
Figure 1
Probability of undergoing OLT (A) by race and (B) according to transplant indication. Log rank P value for race: 0.48; log rank P value for transplant indication: <0.001. Abbreviations: A, Asian Americans; AA, African Americans; C, Caucasians; HCC, hepatocellular carcinoma; OLT, orthotopic liver transplantation.
Figure 2
Figure 2
Probability of death on the waiting list by race. Log rank P value: 0.15. Abbreviations: A, Asian Americans; AA, African Americans; C, Caucasians.
Figure 3
Figure 3
Probability of post-transplant survival by race. Log rank P value: 0.93. Abbreviations: A, Asian Americans; AA, African Americans; C, Caucasians.
Figure 4
Figure 4
Figure 4. Probability of post-transplant HBV recurrence by race. Log rank P value: 0.04. Abbreviations: A, Asian Americans; AA, African Americans; C, Caucasians; HBV, hepatitis B virus.
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References

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