‘No-brainer’
A gastroenterologist who was not involved in the study said that there are two key points in favor of the study.
“The obvious message is that transplant is costly, and patients need to be insured to get a liver transplant, because nobody is paying for this out of pocket. So if more candidates are insured that will reduce disparities and improve access to liver transplant for those who need it,” said Elliot Benjamin Tapper, MD, of the University of Michigan, Ann Arbor.
“It’s a no-brainer that the lack of insurance accessibility for the most vulnerable people in the United States meant that they were dying of cirrhosis instead of being transplanted,” he said in an interview.
He also commended the authors on their use of population-based data to identify outcomes.
“We know how many people are listed for liver transplant, but we don’t know how many people could have been listed. We know how many people are transplanted, but we don’t know how many people with decompensated cirrhosis should have been given that chance. We lacked that denominator,” he said.
“The innovation that makes this particular paper worthwhile is that in the absence of that denominator, they were able to construct it, so we can know from other data sources distinct from the waitlist rolls how many people are dying of cirrhosis,” he added.
No study funding source was reported. Dr. Wahid and Dr. Tapper reported no conflicts of interest.
SOURCE: Wahid N et al. AASLD 2020. Abstract 153.