ArticleDigestive diseases and sciences2026
Investigating Disparities Related to Insurance Status and Access to Locoregional Therapies for Patients with Hepatocellular Carcinoma Awaiting Liver Transplantation.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePatients with hepatocellular carcinoma (HCC) and Medicaid insurance on the liver transplantation (LT) waitlist face higher risks of waitlist dropout, though mechanisms behind this disparity remain unclear. We aimed to assess differences in the use of locoregional therapy (LRT) based on insurance status and whether these differences contribute to waitlist disparities.
methodsWe conducted a retrospective cohort study using Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) data on adult patients (≥ 18 years) waitlisted with standardized HCC Model for End-stage Liver Disease (MELD) exceptions from 1/1/2015 to 12/31/2022. Mixed effects multiple variable logistic regression models were used to evaluate the association between insurance status and LRT receipt, adjusting for key clinical and HCC-related variables.
resultsPatients with Medicaid had higher odds (OR: 1.09; 95% CI: 1.01, 1.18) of receiving LRT compared to patients with private insurance. Additionally, when comparing waitlist time following HCC MELD exception approval for our cohort, Medicaid patients experienced longer median waitlist time (206 days; IQR 88-371) compared to privately insured patients (182 days; IQR 69-313) (p < 0.001).
conclusionContrary to expectations, Medicaid patients were more likely to receive LRT than those with private insurance. These findings highlight the importance of further investigating contributing factors that facilitate these outcomes.
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