Minimal research has been focused on the evaluation process for liver transplant listing. The purpose of this study was to examine whether evaluation MELD score and racial status predict death during the evaluation for liver transplantation at a large, Midwestern urban transplant institute. Methods: Retrospective clinical chart review of patients referred for liver transplantation at a large, Midwestern urban transplant institute from January 2004 through December 2012. Results: 1,767 patients' data included (excluding acute liver failure), 1,394 Caucasian (72.9%) and 373 African American (19.5%). MELD at referral was significantly higher in African American (M 17.0, SD 7.3) than Caucasian patients (M 15.0, SD 6.6), p≤.01. There was no significant difference in the death during evaluation between African American (n 31, 7.9%) and Caucasian patients (n 99, 6.8%), p=.45. Logistic regression predicting patient death during the evaluation process indicated that patients with higher MELD at referral were more likely to die prior to listing decision, but there was no significant difference between African American and Caucasian patients on survival in the evaluation process when accounting for MELD scores. Conclusions: Our results indicate that death during the evaluation process is not significantly associated with racial status after taking into account MELD score at referral. Greater MELD score at initial evaluation, however, was important in predicting patient death in the evaluation process. Efforts to improve processes to have patients with liver disease referred earlier could improve outcomes, particularly for African Americans.

CITATION INFORMATION: Jesse M, Goldstein E, Rebhan N, Ho C.-X, Macaulay T, Bebanic M, Shkokani L, Moonka D, Abouljoud M, Yoshida A. Predicting Survival to Listing for Liver Transplantation: Do MELD and Race Interact? Am J Transplant. 2016;16 (suppl 3).

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