TY - JOUR
T1 - Effect of a Hispanic outreach program on referral and liver transplantation volume at a single center
AU - Kodali, Sudha
AU - Mobley, Constance M.
AU - Brombosz, Elizabeth W.
AU - Lopez, Analisa
AU - Graves, Riki
AU - Ontiveros, John
AU - Velazquez, Marcela
AU - Saharia, Ashish
AU - Cheah, Yee Lee
AU - Simon, Caroline J.
AU - Valverde, Christian
AU - Brown, Alphonse
AU - Corkrean, Julie
AU - Moore, Linda W.
AU - Graviss, Edward A.
AU - Victor, David W.
AU - Maresh, Kelly
AU - Hobeika, Mark J.
AU - Egwim, Chukwuma
AU - Ghobrial, R. Mark
N1 - Copyright © 2024. Published by Elsevier B.V.
PY - 2024/6
Y1 - 2024/6
N2 - Background: Although Hispanic patients have high rates of end-stage liver disease and liver cancer, for which liver transplantation (LT) offers the best long-term outcomes, they are less likely to receive LT. Studies of end-stage renal disease patients and kidney transplant candidates have shown that targeted, culturally relevant interventions can increase the likelihood of Hispanic patients receiving kidney transplant. However, similar interventions remain largely unstudied in potential LT candidates. Methods: Referrals to a single center in Texas with a large Hispanic patient population were compared before (01/2018–12/2019) and after (7/2021–6/2023) the implementation of a targeted outreach program. Patient progress toward LT, reasons for ineligibility, and differences in insurance were examined between the two eras. Results: A greater proportion of Hispanic patients were referred for LT after the implementation of the outreach program (23.2% vs 26.2%, p = 0.004). Comparing the pre-outreach era to the post-outreach era, more Hispanic patients achieved waitlisting status (61 vs 78, respectively) and received a LT (971 vs 82, respectively). However, the proportion of Hispanic patients undergoing LT dropped from 30.2% to 20.3%. In the post-outreach era, half of the Hispanic patients were unable to get LT for financial reasons (112, 50.5%). Conclusions: A targeted outreach program for Hispanic patients with end-stage liver disease effectively increased the total number of Hispanic LT referrals and recipients. However, many of the patients who were referred were ineligible for LT, most frequently for financial reasons. These results highlight the need for additional research into the most effective ways to ameliorate financial barriers to LT in this high-need community.
AB - Background: Although Hispanic patients have high rates of end-stage liver disease and liver cancer, for which liver transplantation (LT) offers the best long-term outcomes, they are less likely to receive LT. Studies of end-stage renal disease patients and kidney transplant candidates have shown that targeted, culturally relevant interventions can increase the likelihood of Hispanic patients receiving kidney transplant. However, similar interventions remain largely unstudied in potential LT candidates. Methods: Referrals to a single center in Texas with a large Hispanic patient population were compared before (01/2018–12/2019) and after (7/2021–6/2023) the implementation of a targeted outreach program. Patient progress toward LT, reasons for ineligibility, and differences in insurance were examined between the two eras. Results: A greater proportion of Hispanic patients were referred for LT after the implementation of the outreach program (23.2% vs 26.2%, p = 0.004). Comparing the pre-outreach era to the post-outreach era, more Hispanic patients achieved waitlisting status (61 vs 78, respectively) and received a LT (971 vs 82, respectively). However, the proportion of Hispanic patients undergoing LT dropped from 30.2% to 20.3%. In the post-outreach era, half of the Hispanic patients were unable to get LT for financial reasons (112, 50.5%). Conclusions: A targeted outreach program for Hispanic patients with end-stage liver disease effectively increased the total number of Hispanic LT referrals and recipients. However, many of the patients who were referred were ineligible for LT, most frequently for financial reasons. These results highlight the need for additional research into the most effective ways to ameliorate financial barriers to LT in this high-need community.
KW - Culturally competent care
KW - Diversity, equity, and inclusion
KW - End-stage liver disease
KW - Hispanic or Latino
KW - Liver transplantation
KW - Referral
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U2 - 10.1016/j.trim.2024.102034
DO - 10.1016/j.trim.2024.102034
M3 - Article
C2 - 38499048
AN - SCOPUS:85188438824
SN - 0966-3274
VL - 84
SP - 102034
JO - Transplant Immunology
JF - Transplant Immunology
M1 - 102034
ER -