Access to orthotopic liver transplantation (OLT) varies among different ethnic groups. The aim of this study was to determine if distance from transplantation center (DT) impedes referral pattern and accessibility to OLT among ethnic groups. This is a retrospective cohort study of all patients evaluated for OLT at our center (20022007). The ZipCode Basic software was used to compute distance between the candidate's residence and transplantation center. Five hundred one patients were evaluated during the study period and there were 439 (87.6%) whites 43 (8.6%) African Americans (AA), and others (3.8%). The median DT was 36.8 miles (range, 0.5231), and there was no significant correlation with the Model for End-Stage Liver Disease (MELD) at presentation (P =.87). Although AA had a higher likelihood of residing closer to a transplantation center they were more likely to have a higher MELD at presentation (20 vs 15.4; P <.001) and less likely to be referred early to initiate OLT evaluation (11.6% vs 26.4%; P =.04). Additionally, type of insurance correlated with higher MELD at presentation. DT was not a contributory factor to the observed access disparity in our patient population, rather the insurance type and disease severity as determined using MELD differed significantly among ethnic groups.
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机译：不同种族之间获得原位肝移植（OLT）的方式有所不同。这项研究的目的是确定与移植中心（DT）的距离是否会妨碍种族之间的推荐模式和OLT的可及性。这是一项对所有在我中心接受OLT评估的患者的回顾性队列研究（20022007）。 ZipCode Basic软件用于计算候选人的住所与移植中心之间的距离。在研究期间对501位患者进行了评估，其中有439位（87.6％）白人，43位（8.6％）的非洲裔美国人（AA）和其他人（3.8％）。中位DT为36.8英里（范围0.5231），与呈现末期肝病模型（MELD）无显着相关性（P = .87）。尽管机管局有较高的可能性靠近移植中心，但他们在诊治时的MELD较高（20 vs 15.4; P <.001），并且不太可能提早开始进行OLT评估（11.6％vs 26.4）。 ％; P = .04）。另外，保险类型与呈现时较高的MELD相关。 DT不是导致我们的患者群体中获得的访问差异的因素，但是使用MELD确定的保险类型和疾病严重性在不同种族之间存在显着差异。
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