Native Americans are far less likely than other racial groups to gain a spot on the national liver transplant list, despite having the highest rate of death from liver disease, according to an analysis of four years of transplant data by the Markup and The Washington Post.

Compared to their total number of deaths from liver disease, White people gain a spot on the transplant list almost three times more often than Native Americans, the data shows. Had transplant rates been equal, nearly 1,000 additional Native people would have received liver transplants between 2018 and 2021.

Native Americans who do win a spot on the list advance to surgery at about the same rate as White people, showing that front-end access is a primary driver of disparity. Among other racial groups, the liver transplant acceptance rate for Black people is slightly lower than for White patients nationally, while Asian Americans have the highest rate of acceptance to the transplant wait list by far.

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