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Excerpt
Approximately 50 % of the adult liver transplants performed at our medical center have involved Hispanic recipients. Although there are some data examining liver transplantation (LT) in Hispanics, no experience has been reported from a center involving such a large proportion of Hispanic patients. AIM: To compare waiting times, etiology of liver disease, Child-Turcotte-Pugh (CTP) score at time of listing, and various outcome measures between Hispanic (HP) and Non-Hispanic patients (NHP) undergoing LT. METHODS: Retrospective analysis was performed in 50 consecutive liver transplants performed at our medical center between 1993 and 1998. Patients were included in this review if they had survived at least 30 days following LT and if a follow-up of at least 90 days was available. RESULTS: Twenty-four HP (48% of those undergoing LT) were compared with 26 NHP. Of the 24 HP, 14 (58%) were male; of the 26 NHP, 14 (54%) were male. Average follow-up after LT was 645 days (range 98-1976 days). The mean age of HP undergoing LT was 50 years; for NHP it was 49 years. Liver disease was due to HCV infection in 50% of both HP and NHP. Alcohol use was the cause or contributor to liver failure in more HP than in NHP (42% vs. 22%, respectively, p=.02). Data regarding mean CTP, mean waiting time (WT) incidence of rejection (Rej), incidence of HCV recurrence and time to HCV recurrence (TR) are summarized as follows: (Table)
Rejection occurred with similar frequency and timing in the two groups. There was no difference in the number of patients in the groups who were classified as having excellent graft function following LT. The incidence of medical noncompliance was similar in the two groups. There were graft losses or patient deaths in the study population. CONCLUSIONS: Alcohol was a more frequent contributor to liver failure in HP in our study. HP may be sicker when referred for LT, as reflected by a higher CTP score at the time of listing. There was a trend toward a shorter WT in HP, possibly because they were somewhat sicker at time of listing. HP and NHP have similar outcomes following LT.
