Submission
| Title: | Characterizing Liver Transplant Waitlist Disparities: Candidates Initially Listed as Inactive |
| Presenter: | Sarah Huber |
| Institution: | Indiana University School of Medicine, Dept of Surgery |
| Authors: | Dr. Katie Ross-Driscoll, PhD, MPH (Indiana University School of Medicine, Dept of Surgery) |
Abstract
| Background/Significance/Rationale: | Liver transplantation is the only curative treatment for end-stage liver disease. Disparities have been documented in access to the transplant waitlist, yet little is known regarding disparities in changes in status once listed. Inactive status on the waitlist prevents candidates from receiving any organ offers and may be the initial listing status or due to a change from active status. Candidates are reactivated if the underlying reason for inactivation is resolved. Our objectives were to describe the characteristics of patients initially listed with inactive status and compare the prevalence of initial inactive status listings across transplant centers. |
| Methods: | This was a retrospective cohort study of candidates waitlisted for liver transplant between 01/03/2023 and 12/02/23, utilizing the Scientific Registry of Transplant Recipients, a national database including all solid organ transplant candidates. 224,736 candidates were included in analysis, and covariates included race, ethnicity, sex, age, BMI, primary payer, MELD at listing, and etiology of liver disease. |
| Results/Findings: | 8,131 (3.62%) candidates were initially listed for liver transplant with inactive status. Although there were statistically significant differences between those listed initially with active status and those listed initially with inactive status in each covariate, these differences did not reach clinical significance. Of the 151 transplant centers, 128 listed any patients with an initial inactive status, with inactive status listings compromising 0 to 49.36% of total listings by transplant center. |
| Conclusions/Discussion: | Despite no significant clinical difference in the characteristics of patients listed with initial inactive status, there is significant variation across transplant centers of the prevalence of listing with initial inactive status. Subsequent investigations will focus on understanding these differences in listing practices between centers. |
| Translational/Human Health Impact: | For the liver transplant process to be equitable each stage of the transplant process must be investigated to identify disparities and potential targets for future interventions to mitigate these disparities. |
