By Katarina A. Lewczyk | Date published: February 18, 2025
Deepika Devuni and Team Explore Psychosocial Determinants and Outcomes of Expedited Liver Transplant Evaluations
Many patients with advanced liver disease are diagnosed late and/or face barriers to care, resulting in elevated short-term mortality in the absence of curative liver transplantation. In a study published in Transplantation Direct, Deepika Devuni, MD, associate professor of medicine in the Division of Gastroenterology, and her team sought to identify patients at the highest risk of requiring an expedited evaluation for liver transplant and study how their outcomes differ from those routinely evaluated.
Dr. Devuni and her team found that 1 in 4 evaluations were performed in the inpatient setting and that expedited evaluation was associated with both higher rates of transplant and death. They also found that despite increased illness severity, post-liver transplant mortality and complications did not differ significantly between expedited and routine evaluation groups. Their study also identified that women who spoke a primary language other than English and women who lived greater than or equal to 50 miles from the liver transplant center, were the most likely to require an expedited evaluation, highlighting potential disparities in access to care.
The study revealed that expedited liver transplant evaluations are a marker of critical illness and are associated with increased pre-liver transplant mortality, however, if deemed to be a transplant candidate, their post-outcomes are similar. Psychosocial determinants, particularly financial concerns and language barriers may contribute to delayed access to routine evaluation, particularly for women. Recognizing and addressing these barriers could improve equity and access to liver transplants.