Effects of rural status on health outcomes in pediatric liver transplantation: A single center analysis of 388 patients
Article first published online: 30 MAR 2011
© 2011 John Wiley & Sons A/S
Volume 15, Issue 3, pages 300–305, May 2011
How to Cite
Park, K. T., Nanda, P., Bensen, R., Strichartz, D., Esquivel, C. and Cox, K. (2011), Effects of rural status on health outcomes in pediatric liver transplantation: A single center analysis of 388 patients. Pediatric Transplantation, 15: 300–305. doi: 10.1111/j.1399-3046.2010.01452.x
- Issue published online: 15 APR 2011
- Article first published online: 30 MAR 2011
- Accepted for publication 8 November 2010
- pediatric liver transplantation;
- liver transplantation;
- access of care;
- outcomes study
Park KT, Nanda P, Bensen R, Strichartz D, Esquivel C, Cox K. Effects of rural status on health outcomes in pediatric liver transplantation: A single center analysis of 388 patients. Pediatr Transplantation 2011: 15: 300–305. © 2011 John Wiley & Sons A/S.
Abstract: Rural status of patients may impact health before and after pediatric LT. We used UI codes published by the USDA to stratify patients as urban or rural depending county residence. A total of 388 patients who had LT and who met criteria were included. Rejection, PTLD, and survival were used as primary outcome measures of post-LT health. UNOS Status 1 and PELD/MELD scores >20 were used as secondary outcome measures of poorer pre-LT health. Logistic regression models were run to determine associations. We did not find any statistically significant differences in pre- or post-LT outcomes with respect to rurality. Among rural patients, there was a general trend for decreased incidence of rejection (25.0% vs. 33.4%; OR 0.64, 95% CI 0.29–1.44), increased risk of PTLD (5.6% vs. 3.4%; OR 1.86, 95% CI 0.36–3.31), and decreased survival (OR 0.85, 95% CI 0.34–2.13) after LT. Rural patients also tended to be sicker at the time of LT than patients from urban areas, with increased proportion of Status 1 (OR 1.17, 95% CI 0.51–2.70) and PELD/MELD scores >20 (OR 1.20, 95% CI 0.59–2.45). From a single center experience, we conclude that rurality did not significantly affect health outcomes after LT, although a larger study may validate the general trends that rural patients may have decreased rejection, increased PTLD, and mortality, and be in poorer health at the time of LT.