Disparities in liver transplantation for metabolic dysfunction-associated steatohepatitis-associated hepatocellular carcinoma

Table 2 Candidate characteristics at listing associated with the likelihood of undergoing liver transplantation for hepatocellular carcinoma in the background of non-alcoholic steatohepatitis, per Cox regression analysis

	Univariable		Multivariable
	HR (95%CI)	P value	HR (95%CI)	P value
Age (years)	1.00 (0.99, 1.00)	0.12	1.00 (1.00, 1.01)	0.18
Male sex	1.17 (1.08, 1.26)	< 0.001	1.16 (1.04, 1.29)	0.01
Race/ethnicity
White	(Reference)		(Reference)
Black	1.07 (0.75, 1.52)	0.71	0.78 (0.54, 1.11)	0.17
Hispanic	0.75 (0.69, 0.82)	< 0.001	0.85 (0.77, 0.95)	0.003
Asian	0.67 (0.54, 0.83)	< 0.001	0.79 (0.63, 0.98)	0.04
Other	0.93 (0.67, 1.28)	0.65	0.98 (0.70, 1.36)	0.89
Height (cm)	1.01 (1.006, 1.01)	< 0.001	1.00 (1.00, 1.00)	0.99
Body mass index (kg/m2)	1.00 (0.99, 1.00)	0.15	--	--
History of diabetes	0.86 (0.80, 0.93)	< 0.001	0.97 (0.89, 1.05)	0.41
Encephalopathy	1.31 (1.22, 1.41)	< 0.001	0.91 (0.83, 0.99)	0.03
Ascites	1.36 (1.26, 1.46)	< 0.001	1.02 (0.93, 1.12)	0.69
Laboratory model for end-stage liver disease score	1.08 (1.08, 1.09)	< 0.001	1.12 (1.11, 1.14)	< 0.001
Albumin (g/dL)	0.82 (0.77, 0.87)	< 0.001	1.03 (0.96, 1.10)	0.45
Serum creatinine (mg/dL)	1.13 (1.07, 1.18)	< 0.001	0.87 (0.81, 0.95)	0.001
Serum bilirubin (mg/dL)	1.14 (1.13, 1.15)	< 0.001	1.03 (1.01, 1.04)	0.001
Receiving hepatocellular carcinoma exception points	0.40 (0.37, 0.43)	< 0.001	0.39 (0.34, 0.44)	< 0.001
Functional status
Unknown	1.40 (1.00, 1.95)	0.049	0.84 (0.59, 1.18)	0.31
10	18.76 (7.59, 46.38)	< 0.001	1.67 (0.40, 7.07)	0.48
20	6.12 (4.35, 8.60)	< 0.001	1.66 (1.13, 2.43)	0.01
30	4.28 (3.17, 5.78)	< 0.001	1.31 (0.95, 1.82)	0.10
40	1.80 (1.40, 2.31)	< 0.001	1.07 (0.82, 1.39)	0.64
50	1.58 (1.25, 1.99)	< 0.001	1.09 (0.85, 1.40)	0.48
60	1.33 (1.06, 1.67)	0.01	1.01 (0.79, 1.28)	0.96
70	1.33 (1.06, 1.65)	0.01	1.08 (0.86, 1.35)	0.53
80	1.08 (0.87, 1.35)	0.49	0.96 (0.76, 1.20)	0.70
90	1.05 (0.83, 1.32)	0.71	0.91 (0.72, 1.15)	0.45
100	(Reference)		(Reference)
On mechanical ventilation	16.54 (7.39, 37.04)	< 0.001	1.25 (0.34, 4.61)	0.74
International normalized ratio	1.31 (1.28, 1.35)	< 0.001	0.96 (0.89, 1.04)	0.32
Working for income	0.97 (0.90, 1.05)	0.51	--	--
United Network for Organ Sharing region
1	(Reference)		(Reference)
2	1.75 (1.42, 2.16)	< 0.001	1.74 (1.42, 2.15)	< 0.001
3	2.62 (2.15, 3.20)	< 0.001	2.57 (2.10, 3.15)	< 0.001
4	1.53 (1.25, 1.89)	< 0.001	1.55 (1.25, 1.92)	< 0.001
5	1.32 (1.08, 1.60)	0.01	1.37 (1.11, 1.68)	0.003
6	1.82 (1.35, 2.46)	< 0.001	1.95 (1.44, 2.65)	< 0.001
7	1.73 (1.39, 2.14)	< 0.001	1.72 (1.39, 2.14)	< 0.001
8	2.01 (1.58, 2.54)	< 0.001	1.74 (1.37, 2.22)	< 0.001
9	1.25 (0.99, 1.59)	0.06	1.25 (0.98, 1.59)	0.07
10	2.54 (2.05, 3.15)	< 0.001	2.44 (1.96, 3.04)	< 0.001
11	2.41 (1.96, 2.97)	< 0.001	2.20 (1.78, 2.72)	< 0.001
Listing era
Pre-MMAT era (1/1/2015-5/31/2019)	(Reference)		(Reference)
Post-MMAT era (6/1/2019-12/31/2021)	1.32 (1.22, 1.42)	< 0.001	1.26 (1.16, 1.36)	< 0.001
			C-statistic = 0.70

HR: Hazard ratio; MMAT: Median model for end-stage liver disease era at transplant.