250 Transplant center level variation in listing patients for liver transplant with initial inactive status

Abstract

Objectives/Goals: Our objectives were to describe the characteristics of patients initially listed with inactive status on the liver transplant waitlist to identify if disparities exist and compare the prevalence of initial inactive status listings across transplant centers. Methods/Study Population: This was a retrospective cohort study of candidates waitlisted for liver transplant between March 1, 2023 and February 12, 2023, utilizing the Scientific Registry of Transplant Recipients, a national database including all solid organ transplant candidates. 224,736 candidates were included in analysis, and covariates included race, ethnicity, sex, age, body mass index, primary payer, MELD at listing, and etiology of liver disease. Results/Anticipated Results: Totally, 8,131 (3.62%) candidates were initially listed for liver transplant with inactive status. Although there were statistically significant differences between those listed initially with active status and those listed initially with inactive status in each covariate, these differences did not reach clinical significance. Of the 151 transplant centers, 128 listed any patients with an initial inactive status, with inactive status listings compromising 0–49.36% of total listings by transplant center. There is significant variation between listing centers in the practice of listing with initial inactive status by both liver disease etiology and across different eras of liver allocation policies. Discussion/Significance of Impact: Despite no significant clinical difference in the characteristics of patients listed with initial inactive status, there is significant variation across transplant centers of the prevalence of listing with initial inactive status. Subsequent investigations will focus on understanding these differences in listing practices between centers.