Liver transplant outcomes in a Canadian First Nations population

BACKGROUND: A higher incidence of autoimmune disorders may predispose First Nations (FN) individuals to higher rates and more severe episodes of rejection, graft loss and mortality following liver transplantation for advanced liver disease. METHODS: A retrospective review of patient outcomes in a single centre providing long-term follow-up care for FN and non-FN patients transplanted for advanced liver disease was conducted. RESULTS: A total of 20 FN and 129 non-FN charts were available for review. FN subjects were younger at transplantation (mean [+/- SD] age 32.4 +/- 4.1 years versus 46.3 +/- 1.4 years; P = 0.00005), less often male (35% versus 58%; P = 0.05), more commonly transplanted for autoimmune hepatitis (30% versus 4.7%; P = 0.006), less often from urban residences (25% versus 74%; P = 0.0001) and less compliant with medical care (20% versus 80%; P = 0.007). After a mean follow-up period of 11.0+1.5 years and 8.4+0.5 years in FN and non-FN subjects, respectively, the incidence and severity of rejection, graft and patient survival were similar between cohorts. CONCLUSiON: Although demographic profiles, nature of the underlying disease and compliance differed, the rates and severity of rejection, graft and patient survival were similar in FN and non-FN patients who underwent liver transplantation for advanced liver disease.