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. 2022 Jun 24;11(13):3646.
doi: 10.3390/jcm11133646.

Sex Disparities in Outcome of Patients with Alcohol-Related Liver Cirrhosis within the Eurotransplant Network-A Competing Risk Analysis

Stephan Listabarth  1 , Daniel König  1 , Gabriela Berlakovich  2 , Petra Munda  3 , Peter Ferenci  3 , Dagmar Kollmann  2 , Georg Gyöeri  2 , Thomas Waldhoer  4 , Magdalena Groemer  1 , Arjan van Enckevort  5 , Benjamin Vyssoki  1
Affiliations

Sex Disparities in Outcome of Patients with Alcohol-Related Liver Cirrhosis within the Eurotransplant Network-A Competing Risk Analysis

Stephan Listabarth et al. J Clin Med. .

Abstract

Alcohol use disorder (AUD) is one of the most important risk factors for the development of alcohol-related liver cirrhosis (ALC). Importantly, psychiatrists are an integral part of the interdisciplinary care for patients with AUD and ALC. The aim of the current study was to investigate whether sex influences the outcome within this group of patients. For this purpose, data of all registrations for liver transplantations due to ALC within the Eurotransplant region from 2010 to 2019 were analyzed for sex disparities using competing risk models and in-between group comparisons. Relevant sex differences in registration numbers (24.8% female) and investigated outcomes were revealed. Risk ratios for a positive outcome, i.e., transplantation (0.74), and those of adverse outcomes, i.e., removal from waiting list (1.44) and death on waiting list (1.10), indicated a relative disadvantage for female patients with ALC. Further, women listed for liver transplantations were significantly younger than their male counterparts. Notably, sex disparities found in registration and outcome parameters were independent of differences found in the prevalence of AUD and liver transplantations. Further research is necessary to identify the underlying mechanisms and establish strategies to ensure equity and utility in liver transplantations due to ALC.

Keywords: addiction; alcohol use disorder; alcohol-related liver cirrhosis; gender medicine; liver transplantation; outcome research.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Risk ratio for transplantation depending on sex by country.
Figure 2
Figure 2
Risk ratio for being removed from the waiting list depending on sex by country.
Figure 3
Figure 3
Risk ratio for having died while on the waiting list depending on sex by country.
Figure 4
Figure 4
Mean age by sex for those patients still on waiting list (still on WL), those who died on waiting list (died while on WL), those removed from WL (removed from WL) and those transplanted (transplanted).
Figure 5
Figure 5
Cumulative incidence per year for males (M) and females (F) and the three outcomes examined (died while on waiting list, removed from waiting list and transplanted).
See this image and copyright information in PMC

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