*Purpose: Although social support is a key component of the pre-transplant evaluation, it’s effect on post-transplant outcomes remains understudied. The purpose of this study was to assess the significance of various forms of pre-liver transplant social support on overall outcomes.

*Methods: After IRB approval, a HIPAA compliant retrospective search of the health system medical database was performed. All liver transplant candidates who were successfully transplanted between 5/2014- 10/2016 were included, yielding 317 patients. Assessment of social support was by psychologist pre-transplant documentation and included presence of partners, mother, father, children and total number of family/friends. Outcomes were assessed up to three years post-transplant: prolonged post-transplant hospital stay (defined as ≥10 days), number of hospitalizations, missed clinic appointments, biopsy proven rejection and mortality. Statistics were calculated using analysis of variance (ANOVA), chi-square, Fisher’s exact test and Wilcoxon Rank Sum Test.

*Results: 317 liver transplants were performed in 196 males and 120 females with a mean age of 57.2. 82.3% were Caucasians, 12.3% were African American and 5.36% were others. There was an increased risk of rejection having ≥1 friend as a support (p = 0.002) rather than a family member. Patients were also likely to have <5 missed clinic appointments if support included a partner (51.0% vs 35.7% p=0.006), wife (52.3% vs 33.9% p <0.001) or ≥3 children (p=0.017).

Patients with support including a female trended towards increase in survival at 3 years (95.1% vs 86.7% p=0.078). Presence of a wife was also more common with 3 years survival (44.3% vs 26.7% p=0.064). No type of support was statistically associated with increased mortality or number of hospitalizations. There was a reduced risk for prolonged length of stay in hospital following transplant if the support team included a female (15.3% vs 7.5% p=0.029) or father (15.3% vs 7.5% p=0.029).

*Conclusions: Social support is a vital part of determining length of stay, rejection rate as well as mortality. Our data revealed a trend towards improved survival, reduced in rejection rate and shortened post-transplant length of stay depending on social support at time transplantation.

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