The majority of research on disparities in liver transplantation is on patients listed for transplant in the OPTN/UNOS database, not patients in the evaluation process for listing. This study reports the outcomes of liver transplant evaluations of Caucasian and African American patients at a single center. Method: Retrospective clinical chart review of patients referred for liver transplantation from January 2004 through December 2012. Results: 1,855 patient referrals, 78.8% (n=1,461) Caucasian and 21.2% (n=394) African American. Most frequent reasons for not listed were medical, patient failure to complete work-up, and patient expired during evaluation (Table 1). African Americans were more likely to not be listed and not be listed due to psychosocial contraindications. Of those not listed for psychosocial contraindications, frequencies of potential barriers (Table 2) indicate higher rates of chemical dependency issues and impaired cognitive functioning in African Americans with mental health and support concerns approaching significance. There were not differences between medical or insurance exclusions.

Conclusions: African Americans are significantly less likely to be listed for liver transplant than Caucasian patients. This is not due to medical issues or insurance, but rather psychosocial barriers. Identifying why African Americans are less likely to complete work-up and psychosocial contraindications will be important in addressing this disparity.

CITATION INFORMATION: Jesse M, Goldstein E, Rebhan N, Ho C.-X, Macaulay T, Bebanic M, Shkokani L, Moonka D, Abouljoud M, Yoshida A. Racial Disparities in the Evaluation for Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).

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