Sex-based disparities in liver transplant rates in the United States

American Journal of Transplantation

Volumn 11, Issue 7, 2011, Pages 1435-1443

  Mathur, A K ^a   Schaubel, D E ^b,c   Gong, Qi ^b   Guidinger, M K ^c,d   Merion, R M ^a,c,d  

^a UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

^b UNIVERSITY OF MICHIGAN   (United States)

^c Scientific Registry of Transplant Recipients   (United States)

^d ARBOR RESEARCH COLLABORATIVE FOR HEALTH   (United States)

Author keywords

Access to transplantation; disparities; end stage liver disease; gender; health policy; liver transplantation; sex related differences

Indexed keywords

ADULT; ARTICLE; CONTROLLED STUDY; END STAGE LIVER DISEASE; FEMALE; GEOGRAPHIC DISTRIBUTION; HEALTH CARE DISPARITY; HUMAN; LIVER GRAFT; LIVER TRANSPLANTATION; MAJOR CLINICAL STUDY; MALE; MORTALITY; ORGAN DONOR; OUTCOME ASSESSMENT; PRIORITY JOURNAL; PROPORTIONAL HAZARDS MODEL; REGISTER; SEX; SEX DIFFERENCE; UNITED STATES;

ADULT; END STAGE LIVER DISEASE; FEMALE; HUMANS; LIVER TRANSPLANTATION; MALE; MIDDLE AGED; UNITED STATES; WAITING LISTS;

EID: 79959854028     PISSN: 16006135     EISSN: 16006143     Source Type: Journal    
DOI: 10.1111/j.1600-6143.2011.03498.x     Document Type: Article

References (42)

1. Freeman RB, Jr,., Wiesner RH, Roberts JP, McDiarmid S, Dykstra DM, Merion RM,. Improving liver allocation: MELD and PELD. Am J Transplant 2004; 9 (Suppl 4): 114-131. (Pubitemid 38859000)
2. Kamath PS, Wiesner RH, Malinchoc M, et al,. A model to predict survival in patients with end-stage liver disease. Hepatology 2001; 33: 464-470. (Pubitemid 32119037)
3. Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC,. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology 2000; 31: 864-871. (Pubitemid 30169932)
4. Wiesner R, Edwards E, Freeman R, et al,. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology 2003; 124: 91-96. (Pubitemid 36055342)
5. Wiesner RH,. Evidence-based evolution of the MELD/PELD liver allocation policy. Liver Transpl 2005; 11: 261-263. (Pubitemid 40458397)
6. Wiesner RH, McDiarmid SV, Kamath PS, et al,. MELD and PELD: Application of survival models to liver allocation. Liver Transpl 2001; 7: 567-580. (Pubitemid 32677880)
7. Cholongitas E, Marelli L, Kerry A, Nair D, Patch D, Burroughs AK,. MELD and gender in the waiting list for liver transplantation. Transplantation 2008; 85: 1509-1510; author reply 1510.
8. Cholongitas E, Marelli L, Kerry A, et al,. Different methods of creatinine measurement significantly affect MELD scores. Liver Transpl 2007; 13: 523-529. (Pubitemid 46605854)
9. Cholongitas E, Marelli L, Kerry A, et al,. Female liver transplant recipients with the same GFR as male recipients have lower MELD scores-a systematic bias. Am J Transplant 2007; 7: 685-692. (Pubitemid 46376449)
10. Moylan CA, Brady CW, Johnson JL, Smith AD, Tuttle-Newhall JE, Muir AJ,. Disparities in liver transplantation before and after introduction of the MELD score. JAMA 2008; 300: 2371-2378.
11. Volk ML, Choi H, Warren GJ, Sonnenday CJ, Marrero JA, Heisler M,. Geographic variation in organ availability is responsible for disparities in liver transplantation between Hispanics and Caucasians. Am J Transplant 2009; 9: 2113-2118.
12. Schaubel DE, Stewart DE, Morrison HI, et al,. Sex inequality in kidney transplantation rates. Arch Intern Med 2000; 160: 2349-2354.
13. Roberts JP, Dykstra DM, Goodrich NP, Rush SH, Merion RM, Port FK,. Geographic differences in event rates by model for end-stage liver disease score. Am J Transplant 2006; 6: 2470-2475. (Pubitemid 44359436)
14. U.S. Scientific Registry of Transplant Recipients. 2009 August 5, 2009; Available from
15. Kalbfleisch JD, Prentice RL,. The statistical analysis of failure time data, 2nd Ed. Hoboken, NJ: Wiley, 2002.
16. Cox DR,. Regression models and life tables (with discussion). J R Stat Soc 1972; Series B: 187-220.
17. Merion RM, Schaubel DE, Dykstra DM, Freeman RB, Port FK, Wolfe RA,. The survival benefit of liver transplantation. Am J Transplant 2005; 5: 307-313. (Pubitemid 40179517)
18. Bryce CL, Angus DC, Arnold RM, et al,. Sociodemographic differences in early access to liver transplantation services. Am J Transplant 2009; 9: 2092-2101.
19. Schaubel DE, Sima CS, Goodrich NP, Feng S, Merion RM,. The survival benefit of deceased donor liver transplantation as a function of candidate disease severity and donor quality. Am J Transplant 2008; 8: 419-425. (Pubitemid 351175358)
20. Ashby VB, Kalbfleisch JD, Wolfe RA, Lin MJ, Port FK, Leichtman AB,. Geographic variability in access to primary kidney transplantation in the United States, 1996-2005. Am J Transplant 2007; 7: 1412-1423. (Pubitemid 46606944)
21. Ellison MD, Edwards LB, Edwards EB, Barker CF,. Geographic differences in access to transplantation in the United States. Transplantation 2003; 76: 1389-1394. (Pubitemid 37430730)
22. Kemmer N, Safdar K, Kaiser T, Zacharias V, Neff GW,. Impact of geographic location on access to liver transplantation among ethnic minorities. Transplantation 2008; 85: 166-170. (Pubitemid 351156845)
23. Mathur AK, Sonnenday, CJ, Merion RM,. Race and ethnicity in access to and outcomes of liver transplantation: A critical literature review. Am J Transplant 2009; 9: 12 (p2662-p2668).
24. Garg PP, Furth SL, Fivush BA, Powe NR,. Impact of gender on access to the renal transplant waiting list for pediatric and adult patients. J Am Soc Nephrol 2000; 11: 958-964. (Pubitemid 30241732)
25. Segev DL, Kucirka LM, Oberai PC, et al,. Age and comorbidities are effect modifiers of gender disparities in renal transplantation. J Am Soc Nephrol 2009; 20: 621-628.
26. Nguyen JT, Berger AK, Duval S, Luepker RV,. Gender disparity in cardiac procedures and medication use for acute myocardial infarction. Am Heart J 2008; 155: 862-868.
27. Parashar S, Katz R, Smith NL, et al,. Race, gender, and mortality in adults > or = 65 years of age with incident heart failure (from the Cardiovascular Health Study). Am J Cardiol 2009; 103: 1120-1127.
28. Raine R,. Does gender bias exist in the use of specialist health care? J Health Serv Res Policy 2000; 5: 237-249.
29. Rathore SS, Chen J, Wang Y, Radford MJ, Vaccarino V, Krumholz HM,. Sex differences in cardiac catheterization: The role of physician gender. JAMA 2001; 286: 2849-2856. (Pubitemid 33126928)
30. Vaccarino V, Rathore SS, Wenger NK, et al,. Sex and racial differences in the management of acute myocardial infarction, 1994 through 2002. N Engl J Med 2005; 353: 671-682. (Pubitemid 41175675)
31. Paulson EC, Wirtalla C, Armstrong K, Mahmoud NN,. Gender influences treatment and survival in colorectal cancer surgery. Dis Colon Rectum 2009; 52: 1982-1993.
32. Ayanian JZ, Cleary PD, Keogh JH, Noonan SJ, David-Kasdan JA, Epstein AM,. Physicians' beliefs about racial differences in referral for renal transplantation. Am J Kidney Dis 2004; 43: 350-357. (Pubitemid 38146334)
33. Bach PB, Pham HH, Schrag D, Tate RC, Hargraves JL,. Primary care physicians who treat blacks and whites. N Engl J Med 2004; 351: 575-584. (Pubitemid 39028925)
34. Tuttle-Newhall JE, Krishnan SM, Levy MF, McBride V, Orlowski JP, Sung RS,. Organ donation and utilization in the United States: 1998-2007. Am J Transplant 2009; 9: 879-893.
35. Scientific Registry of Transplant Recipients. 2009; Available from
36. Fine JP, Gray RJ,. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 1999; 94: 496-509.
37. Ye Y,. Semiparametric analysis of correlated recurrent and terminal events. [Doctoral Dissertation.] Ann Arbor, MI: University of Michigan, 2006.
38. Berg CL, Gillespie BW, Merion RM, et al,. Improvement in survival associated with adult-to-adult living donor liver transplantation. Gastroenterology 2007; 133: 1806-1813. (Pubitemid 350180807)
39. Freise CE, Gillespie BW, Koffron AJ, et al,. Recipient morbidity after living and deceased donor liver transplantation: Findings from the A2ALL Retrospective Cohort Study. Am J Transplant 2008; 8: 2569-2579.
40. Ghobrial RM, Freise CE, Trotter JF, et al,. Donor morbidity after living donation for liver transplantation. Gastroenterology 2008; 135: 468-476.
41. Olthoff KM, Merion RM, Ghobrial RM, et al,. Outcomes of 385 adult-to-adult living donor liver transplant recipients: A report from the A2ALL consortium. Ann Surg 2005; 242: 314-323, discussion 323-315.
42. Hong JC, Yersiz H, Farmer DG, et al,. Long-term outcomes for whole and segmental liver grafts in adult and pediatric liver transplant recipients: A 10-year comparative analysis of 2,988 cases. J Am Coll Surg 2009; 208: 682-689, discussion 689-691.