*Purpose: Liver transplant candidates are chronically ill, requiring complex medical care prior to and after transplant to optimize outcomes. Conscientiousness is one of the Big Five personality traits (conscientiousness, neuroticism, extraversion, agreeableness and openness). High levels of conscientiousness, which includes traits such as self-efficacy (can complete task successfully), orderliness (does not leave mess), self-discipline (gets chores done right away vs wasting time) and deliberation (avoids mistakes), are associated with better outcomes in other chronic care settings. Personality traits have not been described in patients with liver cirrhosis. We aimed to ascertain personality traits in patients with liver cirrhosis deemed eligible for liver transplantation and compared them with a general population sample of 6000 participants (MIDUS).

*Methods: Demographics and personality traits were assessed in liver transplant candidates at two large academic centers (Midwest, West coast) between 2/2018-10/2018 with a brief (<3min) survey (Modified MIDI Personality Measure; 38 questions) and mean scores (1-4) were compared to the general population (GP) ascertained in MIDUS 2 (2005) data and demographics.

*Results: 135 liver transplant candidates were enrolled. The mean age was 58.5 (±9.9) years, 55 (40%) were female, 111 (82%) were White, 6 (4%) Black and 13 (9.6%) Hispanic. The mean calculated MELD at the time of the personality assessment was 15 (±5.9) and the mean time to perform 5x Repeated Chair Stand Test was 13.6 secs (±8.2). Since the assessment, 29 (21%) were transplanted.

The mean conscientiousness level was 3.15 [3.08, 3.22] (compared to MIDUS 3.39; p<0.001), extraversion 3.22 [3.12, 3.31] (MIDUS 3.10; p=0.01), openness 3.13 [3.04, 3.21] (MIDUS 2.9; p<0.001). No difference was seen in agreeableness or neuroticism between the two samples. No differences were seen between etiology (ETOH, HCV, NASH, other) or between centers or pre and post OLT.

*Conclusions: Compared to the general population, liver transplant candidates demonstrated significantly lower levels of conscientiousness. This is an important finding as traits of conscientiousness are qualities required to adhere to complex treatment regimens. Personalized interventions targeted towards levels of different traits such as conscientiousness may improve treatment adherence and possibly post-transplant outcomes. Higher levels in openness and extraversion may facilitate such targeted intervention. Assessment of personality is novel to this field. Further research is needed to further connect personality traits and adherence and outcomes.

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