New System Eliminates Racial Disparities in Liver Transplants
A new system for determining eligibility for liver transplants has improved black liver patients' chances of receiving the life-saving treatment, according to a study in this week's Journal of the American Medical Association, the AP/Houston Chronicle reports. Under the previous system, used until 2002, livers were allocated based on how long a patient had spent on an official waiting list. The system often resulted in sicker patients being passed over for livers in favor of other patients who had waited longer. Under that system, blacks on the organ list had a 50% greater chance of dying or becoming too sick for a liver transplant, according to the study.
The discrepancy could have been related to blacks joining the waiting list later than whites. The reason for that is not clear, but it is thought that blacks with liver disease might obtain treatment later or have less access to liver specialists compared with white patients, the AP/Chronicle reports. The new system, developed in response to a request by the federal government, is based on results from three laboratory tests, which are used to develop a score that predicts a patient's risk of death within three months. The score determines priority for liver allocation.
Richard Freeman, a transplant surgeon at Tufts University School of Medicine who helped design the new liver allocation system, said, "By design, we tried to make [the system] race blind. It looks like we did." While the new system seems to have made racial differences in liver allocation "disappea[r]," the study results indicate that it might favor men over women. Lead author Cynthia Moylan, a transplant fellow at Duke University Medical Center, called for further research into that disparity (Johnson, AP/Houston Chronicle, 11/25).
An abstract of the study is available online. An extract of an accompanying editorial also is available online.