Guidelines for liver transplant candidates outline increased engagement of social supports in the context of patient cognitive impairments. However, there is little direction when limitations in both. The purpose of this study was to examine differences and disparities in cognitive and support concerns identified in liver transplant candidates. Methods: Retrospective clinical chart review of patients referred for liver transplantation from January 2004 through December 2012. Doctoral level psychologists made cognitive recommendations from cognitive screeners and patient interviews. Cognitive accommodations are specific to patient needs, but frequently require additional social support involvement. Social support requirements included at least two adults willing/able to help, drive, and take time off work/other responsibilities post-transplant. Results: 1,753 patient referrals reviewed, 21.3% African American. African Americans were more likely to present with cognitive concerns (8% greater) and support related issues (5.6% greater) and twice as likely to have overlapping cognitive/social concerns as Caucasian patients.

Conclusions: This study identified significant disparities between Caucasian and African American patients in cognitive functioning and support related issues. African Americans may be more likely to present further decompensated, which contributes to cognitive impairments. Efforts towards facilitating support networks of liver transplant candidates (e.g., engagement of community groups) are needed as this may address some disparities in access to liver transplantation.

CITATION INFORMATION: Jesse M, Goldstein E, Macaulay T, Rebhan N, Ho C.-X, Bebanic M, Shkokani L, Abouljoud M, Eshelman A, Yoshida A. Racial Disparities in Cognitive and Social Requirements Prior to Listing for Liver Transplant. Am J Transplant. 2016;16 (suppl 3).

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