PSYCHOSOCIAL AND MEDICAL FACTORS ASSOCIATED WITH RECEIPT OF LIVER TRANSPLANT IN LISTED PATIENT WITH HEPATOCELLULAR CARCINOMA

Background: Patients with hepatocellular carcinoma (HCC) are less likely to receive liver transplantation (LT) than patients without HCC. The aim of this study was to explore sociodemographic, psychosocial, and medical factors associated with progression to LT, versus delisting, in patients with HCC listed for LT. Methods: Prospectively maintained database from a single center tracking all patients diagnosed with HCC from 2005-2022. Amongst those listed for LT, the main outcome was receipt of transplant (versus delisting for any reason). Predictors included sociodemographic, psychosocial, and medical characteristics. Given the exploratory nature, predictors were included in the final multivariable logistic model if univariable logistic regression results approached significant (p < 0.1). Results: Among 341 patients listed with HCC; mean age 59.6 years (SD 6.8); 265 male (77.7%); racial composition was 246 White (72.1%), 50 Black (14.7%), and 45 “other” (13.2%). 261 (76.5%) underwent LT, 80 (23.5%) were delisted (any reason, majority due to disease progression/ medical deterioration). Variables included in the model were age at transplant listing, marital status, whether the patient underwent treatment for HCC, and histories of tobacco use, alcohol abuse, hepatic encephalopathy, diabetes, hypertension, and dyslipidemia. Final model presented in Table 1. Significant predictors of receipt of LT in the final model included younger age at transplant listing, no history of tobacco use, and no history of alcohol abuse. Conclusion: HCC patients are often delisted due to HCC disease progression and/or death while on the LT waitlist. Our data suggests that patients who are listed at a younger age, do not have a history of tobacco use, or of alcohol abuse are more likely to successfully receive LT. Also, contrary to hypotheses, race/ethnicity was not significant suggesting improved equity across these groups. (Table Presented).