ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2016
Use of Population-based Data to Demonstrate How Waitlist-based Metrics Overestimate Geographic Disparities in Access to Liver Transplant Care.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- The INTEGRATE prospective cohort study: Design and methods to evaluate biopsychosocial determinants of outcomes in early liver transplantation for alcohol-associated liver disease.Hepatology communications · 2026Observational
- Demand, Waitlisting and Transplantation Around the World: The Axiomatic View of Scarcity in Liver Transplantation.Clinical transplantation · 2026Article
- Racial and ethnic disparities in liver transplant access vary within and across transplant referral regions.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Article
- Trends and Disparities in Liver Transplantation in the United States: A Nationwide Analysis of Demographic, Clinical, and Socioeconomic Factors (2016-2021).Medical sciences (Basel, Switzerland) · 2025Article
- Inequity in access to liver transplant care: Time to make the invisible visible.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Article
- Palliative care for end-stage liver disease and acute on chronic liver failure: A systematic review.World journal of methodology · 2024Article
- Prognosis of Transplant-Ineligible Patients with Cirrhosis and Acute Kidney Injury Who Initiate Renal Replacement Therapy.Digestive diseases and sciences · 2024Article
- Disparities in Liver Transplantation Rates and Outcomes Among Adults with and without Mental Illnesses.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Identifying and understanding variation in population-based access to liver transplantation in the United States.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2023Article
- Understanding Prognosis: Discrepancy in Prognosis Estimates Between Patients With Cirrhosis and their Hepatologists.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Accurate long-term prediction of death for patients with cirrhosis.Hepatology (Baltimore, Md.) · 2022Article
- AASLD Practice Guidance: Palliative care and symptom-based management in decompensated cirrhosis.Hepatology (Baltimore, Md.) · 2022Article
- Dynamic impact of liver allocation policy change on donor utilization.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- Advance Care Planning and Goals of Care Discussions in Advanced Liver Disease.Current hepatology reports · 2021Article
- County Differences in Liver Mortality in the United States: Impact of Sociodemographics, Disease Risk Factors, and Access to Care.Gastroenterology · 2021Article
- Predictors of Successful Yttrium-90 Radioembolization Bridging or Downstaging in Patients with Hepatocellular Carcinoma.Canadian journal of gastroenterology & hepatology · 2021Article
- Quantifying Sex-Based Disparities in Liver Allocation.JAMA surgery · 2020Article
- Challenges in Abdominal Organ Transplantation During the COVID-19 Pandemic.Frontiers in medicine · 2020Review
- Geographic Disparity in Deceased Donor Liver Transplant Rates Following Share 35.Transplantation · 2019Article
- Geographic disparities in liver supply/demand ratio within fixed-distance and fixed-population circles.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Article
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Abstract
Liver allocation policies are evaluated by how they impact waitlisted patients, without considering broader outcomes for all patients with end-stage liver disease (ESLD) not on the waitlist. We conducted a retrospective cohort study using two nationally representative databases: HealthCore (2006-2014) and five-state Medicaid (California, Florida, New York, Ohio and Pennsylvania; 2002-2009). United Network for Organ Sharing (UNOS) linkages enabled ascertainment of waitlist- and transplant-related outcomes. We included patients aged 18-75 with ESLD (decompensated cirrhosis or hepatocellular carcinoma) using validated International Classification of Diseases, Ninth Revision (ICD-9)-based algorithms. Among 16 824 ESLD HealthCore patients, 3-year incidences of waitlisting and transplantation were 15.8% (95% confidence interval [CI] : 15.0-16.6%) and 8.1% (7.5-8.8%), respectively. Among 67 706 ESLD Medicaid patients, 3-year incidences of waitlisting and transplantation were 10.0% (9.7-10.4%) and 6.7% (6.5-7.0%), respectively. In HealthCore, the absolute ranges in states' waitlist mortality and transplant rates were larger than corresponding ranges among all ESLD patients (waitlist mortality: 13.6-38.5%, ESLD 3-year mortality: 48.9-62.0%; waitlist transplant rates: 36.3-72.7%, ESLD transplant rates: 4.8-13.4%). States' waitlist mortality and ESLD population mortality were not positively correlated: ρ = -0.06, p-value = 0.83 (HealthCore); ρ = -0.87, p-value = 0.05 (Medicaid). Waitlist and ESLD transplant rates were weakly positively correlated in Medicaid (ρ = 0.36, p-value = 0.55) but were positively correlated in HealthCore (ρ = 0.73, p-value = 0.001). Compared to population-based metrics, waitlist-based metrics overestimate geographic disparities in access to liver transplantation.
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