*Purpose: Black patients experience inferior outcomes after liver transplant (LTx). Studies of other outcomes have shown that disparities are partially attributable to variation in quality between hospitals. We assessed whether one-year survival disparities in LTx differed by center quality.

*Methods: Patient data and center-level quality ratings (1 = lowest, 5 = highest) for 1-year patient survival came from SRTR. Patients were included if they were black or white and received a liver transplant between January 1, 2011 and December 31, 2016. We used Cox regression to estimate black-white hazard ratios for one-year post-transplant survival, both overall and by tier. We also estimated hazard ratios for each tier, relative to the lowest rating, stratified by patient race.

*Results: Lower rated centers had a higher proportion of black liver transplant recipients (Table 1). Overall, black patients had a 21% increased risk of mortality one year after liver transplant compared to white patients (95% CI: 1.10, 1.34). Racial disparities in outcomes increased in a stepwise manner with increasing tier, with the exception of the Tier 5 centers, where no disparity was apparent. Increasing center rating conferred improved survival for white patients, but not for black patients, with the exception of Tier 5 centers

*Conclusions: Black patients experience increased disparities in survival in higher quality transplant centers and do not derive the same benefits as white patients from increased center quality, with the exception of Tier 5 centers. Further research is needed to elucidate this relationship in order to inform center-based interventions to reduce disparities.

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