An Evaluation of Clinical Outcomes of Liver Transplant Recipients and Impact of Clinical Indicators

• Activity Number: 126
• Type: Contributed
• Date/Time: Monday, August 1, 2011 : 8:30 AM to 10:20 AM
• Sponsor: Section on Health Policy Statistics
• Author(s): Alexia Melissa Makris*+ and Yiliang Zhu
• Companies: University of South Florida and University of South Florida
• Keywords: Cox Proportional Hazard Model ; race and ethnicity ; failure time data ; liver transplantation ; time-varying covariates ; disparities

Abstract

Liver transplantation is accepted as the therapeutic option of choice for the individuals with end-stage liver disease. Although it provides reasonable survival, the outcomes of transplantation can vary and are dependent on several patient and non-patient related factors. We focus on liver transplant candidates registered nation-wide between 2002 and 2009. Potential determinants include clinical prognostic and demographic factors. Cox proportional hazards models were used. Potential determinants include clinical prognostic and demographic factors. Cox proportional hazards models were used to quantify the waiting time and survival time, and also to screen the determinants which included a large number of demographic, clinical, and prognostic factors. While we examine the disparity factor of race, we adjust for known covariates such as age, gender, diagnosis, diabetes, body mass index (BMI), hospitalization status at listing, receipt of dialysis, albumin and prior malignancy which was already established in the literature as significant. Under the organ allocation scheme dominated by the MELD score, variation in waiting time remained across regions and race.