Women with hepatocellular carcinoma (HCC) are less likely to receive a deceased-donor liver transplant (DDLT) and more likely to die while wait-listed than men, according to a study published online Sept. 4 in JAMA Surgery,
David C. Cron, MD, from Massachusetts General Hospital in Boston, and colleagues examined whether there are sex- or size-based disparities in access to DDLT. The analysis included 31,725 US adult wait-listed liver transplant candidates receiving exception scores for HCC (Jan. 1, 2010, to March 2, 2023).
The researchers found that compared with men, women had a lower one-year cumulative incidence of DDLT (50.8 versus 54.0 percent) and a higher one-year cumulative incidence of death or delisting for health deterioration (16.2 versus 15.0 percent). Compared with men, women had a lower incidence of DDLT after adjustment, but without accounting for size (subdistribution hazard ratio (SHR), 0.92; 95 percent confidence interval (CI), 0.89 to 0.95), as well as a higher incidence of death. or delisting (SHR, 1.06; 95 percent CI, 1.00 to 1.13). When adjusting for height and weight, there was no association seen between female sex and incidence of DDLT or death or delisting, overall, but short women (<166 cm) were still less likely to undergo a transplant (SHR, 0.93; 95 percent CI , 0.88 to 0.99).
“These findings suggest that for liver transplant candidates wait-listed with exception scores, additional changes to allocation policy are needed to resolve the sex disparity, including solutions to improve access to livers for smaller candidates,” the authors write.
More information:
David C. Cron et al, Sex and Size Disparities in Access to Liver Transplant for Patients With Hepatocellular Carcinoma, JAMA Surgery (2024). DOI: 10.1001/jamasurg.2024.3498
Mohamad El Moheb et al, Size Matters—Unpacking Sex-Based Disparities in Liver Transplants, JAMA Surgery (2024). DOI: 10.1001/jamasurg.2024.3506
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Citation: Women with liver cancer less likely than men to receive liver transplant (2024, September 9) retrieved 9 September 2024 from
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