ArticlePediatric transplantation2026
Racial Disparities in Pediatric Patients With Cholestatic Liver Disease Undergoing Liver Transplant: A UNOS Database Study.
Article in Pediatric transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Early Living Donor Liver Transplantation in Biliary Atresia: The Next Challenge Is Equity.Pediatric transplantation · 2026Article
- Racial Disparities in Pediatric Patients With Cholestatic Liver Disease Undergoing Liver Transplant: A UNOS Database Study.Pediatric transplantation · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
introductionCholestatic liver disease is the leading indication for pediatric liver transplantation (LT). Early detection and optimal care are often limited by socioeconomic barriers including racial disparities. This study examined racial disparities in demographics, waitlists, and post-transplant outcomes among pediatric LT recipients with cholestatic liver disease.
methodsAll pediatric patients (≤ 18 years) who were listed or received LT for cholestatic liver disease (Biliary Atresia, Caroli's, Choledochal cyst, PSC, PFIC, Alagille, and other non-specified cholestatic diseases) between 2010 and 2024 were retrospectively identified using the United Network for Organ Sharing (UNOS) database. The primary outcome of the study was waitlist mortality, graft failure, and post-transplant mortality stratified by race, specifically non-Hispanic whites (NHW), non-Hispanic blacks (NHBs), Hispanics, and others.
results3501 pediatric patients underwent LT for cholestatic liver disease: 1663 (47.5%) were NHW, 795 (22.7%) were Hispanic, 648 (18.5%) were NHB, and 395 (11.3%) were of other races. NHW recipients were more likely to have private insurance (56.7% vs. 18.2%, p < 0.01) and experienced shorter waitlist times than Hispanic patients (175.9 vs. 189.4 days, p < 0.01). The 1-year survival rate was lower in NHB than in NHW recipients (94.8% vs. 96.8%, p = 0.04), with no significant difference at 5 years (93.7% vs. 95.4%, p = 0.13). Hispanic patients had similar 1-year (95.9%, p = 0.26) and 5-year (93.3%, p = 0.06) survival rates to NHW. NHB recipients had a significantly increased risk of mortality with a hazard ratio (HR) of 1.53 [95% CI: 1.05-2.22]. Predictive modeling using extreme gradient boosting showed a relative likelihood of increased mortality in NHB (3.91%) and Hispanic (3.14%) recipients.
conclusionRacial disparities significantly affect post-transplant outcomes in pediatric cholestatic liver disease. NHB and Hispanic children face a risk of higher mortality despite similar waitlist outcomes, highlighting the need for targeted interventions to promote equity in pediatric liver transplantation.
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