Geographic disparity in access to liver transplantation has been well described. Candidates may travel to be listed in OPOs with better access. We hypothesized that listing outside of the resident OPO requires substantial resources and would be limited to only certain patients.

METHODS: We selected 19,572 adult candidates [d1] whose primary payor were not veterans administration insurance [d2] listed between 2012-2014 using SRTR data. Outcome was waitlisted in OPOs other than the resident OPO ("travel"). We examined the association between travel and candidate characteristics including age, gender, race/ethnicity, education, insurance, and MELD at listing.

RESULTS: In total 4,423 (22.6%) candidates traveled (Table 1). Candidates of age>65 were 13% less likely to travel (aOR=_0.780.87_0.97, p=0.01). Female candidates were 25% less likely to travel (aOR=_0.700.75_0.80, p<0.001). African-American and Hispanic candidates were less likely to travel than white candidates (aOR=_0.430.49_0.55 and aOR=_0.420.46_0.50, p<0.001). Candidates with Medicare, Medicaid, and other were less likely to travel than private insurance (aOR=_0.600.66_0.72, aOR=_0.350.39_0.43, aOR=_0.400.58_0.84, p<0.01). Candidates with higher MELD at listing were less likely to travel than MELD 6-14. Interesting, candidates with higher education level were less likely to travel (Table 2, Figure).

CONCLUSION: Travel to an OPO outside of one's OPO of residence is a treatment modality primarily available to candidates with lower MELD, male candidates, candidates age<65, white candidates, and candidates with private insurance. This situation unfortunately converts geographic disparities to socioeconomic and racial disparities.

CITATION INFORMATION: Zhou S., Massie A., Gentry S., Segev D. Factors Associated with Listing for Liver Transplantation in an OPO Other Than the Resident OPO Am J Transplant. 2017;17 (suppl 3).

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