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Molinari et al. Hepatoma Res 2018;4:56 Hepatoma Research
DOI: 10.20517/2394-5079.2018.71

Original Article Open Access

Adult African Americans undergoing cadaveric liver
transplantation for hepatocellular carcinoma within
the Milan criteria have the lowest 5-year survival
among all the ethnic groups in the United States:
analysis of USA national data between January 2002

and June 2013

1
2
1
Michele Molinari , Subhashini Ayloo , Allan Tsung , Patrick Bou Samra , Naudia Jonaissaint 3
1
1 Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
2 Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.
3 Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Correspondence to: Prof. Michele Molinari, Division of Transplantation, University of Pittsburgh Medical Center, 3459 Fifth Avenue,
N758, Pittsburgh, PA 15213, USA. E-mail: molinarim@upmc.edu
How to cite this article: Molinari M, Ayloo S, Tsung A, Bou Samra P, Jonaissaint N. Adult African Americans undergoing cadaveric liver
transplantation for hepatocellular carcinoma within the Milan criteria have the lowest 5-year survival among all the ethnic groups in the
United States: analysis of USA national data between January 2002 and June 2013. Hepatoma Res 2018;4:56.
http://dx.doi.org/10.20517/2394-5079.2018.71

Received: 1 Jun 2018 First Decision: 23 Jul 2018 Revised: 7 Aug 2018 Accepted: 10 Aug 2018 Published: 20 Sep 2018

Science Editor: Guang-Wen Cao Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Aim: To investigate the potential effects of recipient ethnicity on the short and long-term outcomes of patients
undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC) in the United States. We performed
a retrospective study using the standard transplant analysis and research (STAR) files with the primary aim of
assessing short and long-term survival of different ethnic groups undergoing LT for HCC in the United States.

Methods: The study population was represented by adults (age ≥ 18) who received a first-time cadaveric LT for
HCC between 1 Jan 2002 and 30 Jun 2013. Recipients of LT for other primary and secondary malignancies were
excluded. Other exclusion criteria were: transplants from grafts recovered from living or donors after cardiac
death, split grafts, multi-visceral or redo transplants, and LT performed across ABO incompatible blood groups.
Survival analysis stratified by recipient ethnicity was performed using the Kaplan-Meier method. Proportional
hazard model analysis was used to assess the effect of predictors of survival. Characteristics utilized in the Cox
regression model were selected a priori.

Results: The study population was represented by 6048 recipients with an average age of 58 years and 20% being
females. The majority of patients were Caucasians (67%), followed by Hispanics (14.2%), African Americans
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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