*Purpose: To determine the impact of Vancomycin Resistant Enterococcus (VRE) colonization on 90-day Liver Transplant (LT) waitlist outcomes.

*Methods: Single center, retrospective observational study of LT candidates listed between 1/1/15-6/30/18. Patients were followed for 90 days post-listing until transplant, death, or removal. Patients were stratified as VRE colonized or not at the time of listing based on VRE rectal surveillance culture results. Demographics, comorbidities, and waitlist outcomes were compared between groups. Chi-square test was used for comparing categorical variables. Student’s t-test and Wilcoxon Rank Sum test were used for comparing continuous variables expressed as means and medians, respectively. Competing risks regression assessed 90-day waitlist outcomes.

*Results: 221 candidates were added to the liver waitlist during the study period. 190 (86%) candidates had VRE surveillance cultures prior to listing with 65 (34%) colonized. VRE colonized patients had a higher rate of a previous transplant (12.3% vs 2.4%, p<0.01), but did not differ significantly on other baseline information (Table 1). In competing risks regression, MELD at listing (Hazard Ratio (HR)=1.09 (1.06-1.13), p<0.01), primary diagnosis for cancer (HR=2.92 (1.07-7.99), p=0.04), and male gender (HR=2.14 (1.05-4.38), p=0.04) were independent predictors of transplant. Only Model for End Stage Liver Disease (MELD) at listing was significantly associated with mortality (HR=1.13 (1.09-1.17), p<0.01). After adjusting for MELD at listing, VRE colonization was not significantly associated with mortality (HR=1.08 (0.44-2.69), p=0.86) or transplant (HR=0.92 (0.49-1.74), p=0.81).

*Conclusions: Enteric VRE colonization at the time of liver listing was common but not associated with 90 day competing outcomes of transplant or mortality.

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