White Women Have Lower Liver Transplant Rates Compared With White Men

Socioeconomic variables affect the liver transplant gender gap.

Women who are White, aged over 45 years, or had Medicare or private insurance have lower rates of liver transplant compared with men, according to study results presented at the American College of Gastroenterology (ACG) 2022 Annual Meeting, held from October 21 to 26, 2022, in Charlotte, North Carolina, and virtually.

Researchers analyzed data from the Nationwide Inpatient Sample (NIS) between 2016 and 2019. They identified patients who had a liver transplant according to the International Disease Classification of Disease10th Procedure Coding System (ICD-10-PCS) and used multivariate logistic regression to assess the effect of sex on liver transplantation in different demographic groups.

A total of 29,050 liver transplants were conducted, with 10,501 (36.1%) occurring in women. White women were less likely to receive a liver transplant compared with White men (adjusted odds ratio [AOR], 0.74, P <.001), after adjustment for comorbidities and socioeconomic and demographic factors. Black and Hispanic women did not have a statistically significant difference in transplant rate compared with Black men (AOR, 1.05, P =.568) and Hispanic men (AOR, 0.95, P =.472), respectively.

Further patient-level research is needed to help understand gender disparities in liver transplants to better advocate for patients suffering from end-stage liver disease.

Women aged over 45 years also had lower transplant rates compared with men in the same age group (AOR, 0.77, P <.001). In addition, women with Medicare (AOR, 0.76, P <.001) or private insurance (AOR, 0.77, P <.001) had lower transplant rates vs men with Medicare or private insurance, respectively, and women with Medicaid did not (AOR, 1.01, P =.854).

Female sex was independently associated with lower transplant rates across all income quartiles and geographic distributions.

“This study highlights the complex interactions between gender disparities and different socioeconomic variables,” the investigators commented. “Further patient-level research is needed to help understand gender disparities in liver transplants to better advocate for patients suffering from end-stage liver disease.”

References:

Mansour M, Mahfouz R, Darweesh M, Obeidat AE, Basida SD, Ali A. Investigating gender disparities in liver transplant recipients in the United States. Abstract presented at: ACG 2022 Annual Meeting; October 21-26, 2022; Charlotte, NC. Abstract A0463.