Post Liver Transplant Patient Outcomes and Survival: Impact of Demographics and Psychosocial Factors

Abstract

Many persons with cirrhosis and eventually end stage liver disease (ESLD) are unable to meet the eligibility criteria for becoming a candidate for a liver transplant (LT). Currently, approximately 17,000 persons in the United States (U.S.) need a LT to survive, though only about 8,000 LT’s are performed each year; a LT is the only option for survival. The genesis of ESLD is most typically attributed to alcohol abuse, chronic hepatitis B or C, non-alcoholic fatty liver disease, autoimmune hepatitis, biliary atresia (new-born liver disease), or metabolic disorders. The etiology of adult LT recipients in 2017 for the U.S. were non-alcoholic fatty liver disease (31%) and alcoholic liver disease (25.1%). This study is guided by the Critical Social and Stress Coping Theories to assist in exploring potential health disparities prevalent in LT recipients. The aim of this study is to explore the psychological and demographic characteristics of 1297 LT recipients between 2010-2020 in an Indiana transplant center and identify potential disparities impacting 10-year survival rates. This exploratory, cross-sectional secondary analysis found that race/ethnicity, histories of mental illness, substance use/abuse, social support networks, education, marital status, and insurance sources held no statistical significance for 10-year survival rates. To date the screening process for each of those demographics appears to be effective and efficient. A Cox regression analysis revealed having a history of criminality significantly impacts 10-year survival rates. To address these findings the consideration for increased support and follow-up for patients with a history of criminality may positively impact 10-year survival rates.