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Survival rates for Aboriginal, Torres Strait Islander LT recipients similar to non-islanders

Children and adults of Aboriginal and Torres Strait Islander descent in Australia did not have worse overall survival rates after liver transplantation compared with patients of non-Aboriginal and Torres Strait Islander descent in a recent study.

Alan J. Wigg, MBBS, FRACP, PhD, of the Hepatology and Liver Transplant Medicine Unit, Flinders Medical Centre, Australia, and colleagues conducted a retrospective review of data found in the Australia and New Zealand Liver Transplant registry between 1985 and 2012. Forty-five Aboriginal and Torres Strait Islander patients (ATSI) underwent primary liver transplantation among a cohort of 3,493 transplant recipients. They were compared with non-ATSI patients to determine transplantation survival rates.

Alan J. Wigg

There were 14 pediatric liver transplantations among pediatric ATSI patients (n=636; median age, 9.6 years) and 31 adult transplants in the adult cohort (n=2,857; median age, 44.5 years). No differences were observed between median survival rates for pediatric ATSI and non-ATSI patients (6.5 years vs. 9; P=.9) or adult ATSI and non-ATSI patients (7.1 years vs. 6.3 years; P=.8). Cumulative 5- and 10-year survival rates in the ATSI cohort were 78.6% and 65.5% in children and 84.6% and 61% in adults, respectively. Graft survival rates for the same periods were 72.4% and 63.4% in children and 84.6% and 61% in adults, respectively.

“In a highly selected group of ATSI patients the outcomes (patient and graft survival) are no worse than non-ATSI populations,” Wigg told Healio.com/Hepatology.

In an Australian pediatric population of 3.8 million in 2001, 4.7% were ATSI children, but only 2.2% were in the pediatric transplantation cohort. ATSI adults made up 1.8% of the overall 15.6 million adult population in 2001, but represented only 1.1% of the adult transplantation cohort. This led researchers to determine the ATSI child and adult populations were underrepresented.

“What is slightly concerning is the very low numbers of ATSI patients who underwent liver transplantation, given their prevalence in our population and the high prevalence of liver disease in this population,” Wigg said. “Also concerning was the trend toward poorer outcomes in ATSI children from remote areas.”

Disclosure: The researchers report no relevant financial disclosures.