*Purpose: Black liver transplant recipients experience poor post-transplant outcomes; little is known about potential mechanisms of this disparity. We investigated whether racial disparities in liver transplant outcomes varied by transplant center characteristics.

*Methods: Data on adult (age > 18), non-Hispanic black or white deceased donor liver transplant recipients between January 1st, 2010 and December 31st, 2017 were obtained from SRTR. Our primary outcome was time to graft failure our death. Center-level characteristics included transplant volume (in tertiles), proportion of minority patients (in tertiles), transplant center quality (the SRTR 5-tier system for observed outcomes), and geographic region (Northeast, Midwest, South, and West). Center characteristics were defined for each year and assigned by year of transplant. We used hierarchical survival analysis to estimate the association between race and survival, accounting for effect modification by center characteristics, clinical and demographic covariates, and correlation of outcomes within centers.

*Results: We included 34,114 black and white liver transplant recipients; approximately 10% (n = 3,609) were black. Across all centers, black recipients had a 20% higher risk of poor outcomes (HR: 1.19, 95% CI: 1.10, 1.29). Racial disparities in liver transplant outcomes were consistent regardless of transplant characteristics, with no statistically significant effect modification (Figure 1).

*Conclusions: Racial disparities in liver transplant outcomes were consistent regardless of transplant center characteristics, suggesting a pervasive mechanism of disparity. Further research is needed to clarify the role that transplant centers can play in mitigating racial disparities in liver transplant outcomes.

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