CHICAGO — Blacks waiting for a liver transplant used to be more likely to die than whites. Now they have the same chance of getting a life-saving organ under a nationwide system that puts the sickest patients first, a new study found.
Racial differences disappeared when the old system was scrapped in 2002, according to the federally funded study, the first assessment of how blacks fared after the change.
“By design, we tried to make it race-blind. It looks like we did,” said Dr. Richard Freeman, a transplant surgeon at Tufts University School of Medicine in Boston, who helped create the system and was not involved in the study.
But the research, appearing in today’s Journal of the American Medical Association, suggests the system might favor men over women. Dr. Cynthia Moylan, the study’s lead author and a transplant fellow at Duke University Medical Center in Durham, N.C., called for more research on gender differences.
The nation faces a shortage of livers from deceased donors, with nearly 16,000 people waiting. About 6,500 liver transplants were performed last year, but 1,602 people died waiting for a new one.
Under the old system, which relied heavily on how long a patient spent on an official waiting list, sicker patients were passed over in favor of those waiting longer.
Before the change, 810 blacks, or 49 percent of blacks on the waiting list, got transplants. Meanwhile, 10,202 whites, or 52 percent of whites on the list, got transplants.
In the years after the change, 849 blacks, or 47 percent, got transplants compared with 8,492 whites, or 42 percent.
For women, MELD wasn’t an improvement. The study found that women had a 30 percent greater chance of dying or becoming too sick for transplant with the new scoring system. The gender difference wasn’t significant before.
