Factors impacting return to employment after liver transplantation
Hassan M, Abouljoud M, Sadik N, Mazur A, Elbanna A, Yoshida A, and Jesse M. Factors impacting return to employment after liver transplantation. Am J Transplant 2018;18(Suppl 4):871.
Am J Transplant
Liver transplantation (LT) prolongs the lives of patients with end-stage liver disease (ESLD). Post-LT, 22-55% of patients return to some form of active employment. Age at transplant, pre-transplant employment status, male gender, and functional status are independent predictors of employment post-LT. Functional status remains the only identified modifi able factor that consistently predicts post-LT employment. Decreased employment remains a significant Barrier in the functional recovery of post-LT patients. Our study aims to identify additional factors impacting return to employment. METHODS: Retrospective chart review of patients who underwent evaluation for liver transplantation between January 1, 2010 and December 31, 2012 and were transplanted (≤64 at time of transplant, excluded patients presenting in acute liver failure or those who expired within 1-year of transplant). Univariate analyses were performed to determine impact of age, gender, race, MELD score at transplant, donor status, concurrent hepatocellular carcinoma, marital status, type of insurance, history of substance abuse, pulmonary hypertension, hepatorenal syndrome, or history of heart disease on likelihood of return to work (part-or full-time). RESULTS: In total, 186 patients were included; 41 (22.0%) returned to some level of employment, whereas 145 (77.9%) did not. Liver transplant recipients who returned to work were significantly younger (M 50.5, ±10.7) than those who did not return to work (M 55.1, ±7.4), p=0.01. No patients with only Medicare insurance returned to work, but patient with private insurance were significantly more likely to return to work (29.7%) than other insurances (10.5%), p=0.002.Patients with any substance abuse history were less likely to return to work (16.5%) than those with no substance abuse histories (29.9%), p=0.03. None of the other variables were significant with return to employment post-LT. DISCUSSION: Our study suggests that younger age at transplant, private insurance, and no history of any substance abuse is associated with a greater likelihood to return to work post-LT. Interventions aimed at assisting patients with substance abuse histories to return to work may be benefi cial. Further studies examining the aforementioned factors would be benefi cial in identifying possible areas of functional status optimization for post-LT patients.