Keywords: Asian, disparity, liver transplantation, Share 35 policy, United Network for Organ Sharing
Studies addressing ethnic disparities and trends in liver transplantation for Asian population is scant. The objective of this study was to examine the impact of Share 35 policy on Asian patients’ access to liver transplantation and outcomes since its implementation in June, 2013. A total of 11,910 white and Asian adult patients registered for deceased donor liver transplantation between 2012 and 2015 were identified from UNOS database. Logistic regression and Cox models with adjustment for demographic, clinical, and geographic factors were used to model the access to liver transplantation and patient survival comparing pre- and post-Share 35 periods. In post-Share 35 periods, Asian patients had higher proportions of receiving liver transplantation, similar transplant rates as whites (OR: 1.15, 95% CI: 0.80-1.67) but experienced significantly longer waiting time (HR: 0.56, 95% CI: 0.34-0.92) before they received liver transplantation. We concluded that Asian patients are still at greater risk of disparities in access to liver transplantation under the Share 35 policy. Long term follow-up researches are recommended to continuously evaluate the effectiveness of the policy.