Abstract
We study how reduced scarcity affects racial disparities in liver transplantation. When direct-acting antivirals dramatically reduced liver demand from Hepatitis C (HCV +) end-stage liver disease patients, we show that transplants increased by 56.6% among White patients without HCV versus only 11.9% for Black patients. The transplant rate rose (19.5pp) and waiting times fell (31.1%) exclusively for White HCV − patients. These patterns are surprising because transplant priority depends on disease severity, and Black patients join the waiting list in worse liver health. A decomposition suggests that differences in age, payer, blood type, and geography explain only 19.5% of the differential gains.
Citation: Callison, K; Darden, Michael E., Teltser, Keither; 2026. Scarcity and Health Inequality: Evidence from Liver Transplantation. ScarcityInequalityLivers.pdf
