Liver transplants, geographic, demographic, and racial data. A look into what matters most

Abstract

Purpose of review: Liver transplantation is the only curative therapy for end stage liver disease. With over 11,000 liver transplants performed in the United States in 2024, it is one of the most frequently performed solid organ transplants, second only to kidney transplantation. Disparities relating to race, sex, geography and socioeconomic status in liver transplant have been examined in a multitude of studies.

Recent findings: Over the past decades, several policy changes have been implemented to allow for a more objective approach to organ allocation. However, even with the initiation of the system of allocation based on acuity circles in 2020, disparities remain present. Technological advances in organ procurement, such as the development of organ care systems, may aid in expanding the donor population which could neutralize the disparities that exist in liver transplantation, by decreasing scarcity. Additionally, improvements in survival after transplant may be observed.

Summary: Since the start of liver transplantation in the 1960s there have been strides made allowing patients with end stage liver disease to gain access to this potentially life-saving therapy. However, opportunities for improvement remain in reducing the disparities that persist.

Keywords: Cold ischemia storage; Healthcare disparities; Liver transplant; Normothermic regional perfusion; Organ care system.