Do Black patients have worse survival rates after a liver transplant for hepatocellular carcinoma?
Liver transplant is a key treatment for hepatocellular carcinoma (HCC), the most common type of liver cancer. However, research shows that outcomes after transplant are not the same for all racial groups. A 2025 systematic review and meta-analysis found that Black patients have significantly worse survival rates after liver transplant for HCC compared to White patients. This disparity persists even after accounting for other factors like tumor stage and liver function.
What the research says
A 2025 systematic review and meta-analysis of 12 retrospective cohort studies examined the link between ethnicity and post-transplant outcomes in HCC patients 3. The analysis found that Black patients had a 27% higher risk of death after liver transplant compared to White patients (HR = 1.27; 95% CI = 1.12, 1.44; P = 0.002) 3. In contrast, Asian and Hispanic patients had similar survival chances to White patients 3. The study noted that Black patients generally showed the poorest overall patient and graft survival across all follow-up durations 3. These findings are consistent with earlier research showing that Black race is associated with lower rates of receiving HCC therapy and greater treatment delays, which can contribute to worse outcomes 9. A 2023 study of national transplant data also found that after a 2015 policy change, Black patients had lower odds of receiving a liver transplant for HCC compared to White patients 11. Together, these studies suggest that disparities in access to care and treatment contribute to the survival gap.
What to ask your doctor
- What factors might contribute to worse outcomes for Black patients after liver transplant for HCC?
- Are there steps I can take to reduce my risk of complications or improve my chances of a successful transplant?
- How does my hospital or transplant center track and address racial disparities in transplant outcomes?
- Should I be screened for any additional health issues that could affect my transplant results?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.