Transplantation bias, misconceptions endure for alcohol-, obesity-related liver disease

02 Nov 2021
Transplantation bias, misconceptions endure for alcohol-, obesity-related liver disease
Patients with a higher MELD score are given priority for a liver transplant.

Bias and misconceptions about liver transplantation persist for patients with alcohol- (ALD) and obesity-related liver disease (OLD), a study has found.

A team of investigators evaluated patients, medical students, residents, fellows, and attending physicians for bias and misconceptions regarding liver transplantation for patients with ALD and OLD through a survey asking participants whether ALD patients who continue/discontinue drinking alcohol or those with OLD who do/do not commit to a weight-loss regimen deserve equal transplantation rights.

A Likert scale was employed for the responses. In addition, participants estimated 5-year survival and advanced fibrosis recurrence following liver transplantation.

The primary outcome was bias measured by expected agreement or disagreement to questions using a Likert scale, significant underestimation of a 5-year survival rate after LT, and significant overestimation of 5-year advanced fibrosis recurrence after LT.

Of the 381 participants included in the analysis, 153 were residents/fellows, 31 attending physicians, 98 medical students, and 99 patients.

A greater proportion from the four participating groups were either neutral or disagreed with equal liver transplantation rights for ALD patients who discontinue drinking compared with OLD patients who commit to a weight-loss programme.

Notably, only the attending physician group had a majority estimating >60 percent 5-year survival after transplantation in patients with ALD and OLD (p<0.05). All participating groups had a majority estimate >20 percent 5-year advanced fibrosis recurrence in both patient groups (p>0.05).

“Bias and misconceptions surrounding ALD and OLD may lead to transplant listing inequities,” according to the investigators.

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