*Purpose: Hospital admissions after liver transplant are common, costly, and associated with poor outcomes. While survival disparities are well-documented for Black liver recipients, little is known about disparities in hospital admissions after transplant. We used data from a large, Southeastern transplant center to describe racial differences in hospitalization characteristics after liver transplant.

*Methods: We included non-Hispanic Black and White adults who received a liver transplant from 2010 to 2018. Patient-level outcomes included the timing of first admission after initial discharge; admission-level outcomes included the reason, urgency, and intensity of each admission. Generalized linear models were used to estimate the association between race and each outcome, adjusted for demographic and clinical factors. For admission-level outcomes, we used generalized estimating equations (GEE) to account for multiple admissions per patient.

*Results: We included 631 White and 190 Black liver recipients with 2,262 post-transplant hospital admissions. Black patients had a lower hazard of admission in the first 6 months after transplant (HR: 0.77, 95% CI: 0.55, 1.08) and a higher hazard after 6 months (HR: 1.37, 95% CI: 0.77, 2.43). For each admission, Black patients had a higher prevalence of rejection as a cause of admission (PR: 1.40, 95% CI: 1.04, 1.89), and a lower prevalence of other causes. For each admission, Black patients were more likely to be admitted emergently (OR: 1.89, 95% CI: 1.29, 2.77), but less likely to go to the ICU (RR: 0.66, 95% CI: 0.48, 0.90).

*Conclusions: At a single transplant center, Black patients appeared to have different hospital admission characteristics after liver transplant compared to White patients. Differences in admission urgency and intensity may point to opportunities to prevent admissions among Black patients.

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