Impact of recipients' socio-economic status on patient and graft survival after liver transplantation: The IsMeTT experience

Salvatore Gruttadauria, Giuseppe Grosso, Antonio Mistretta, Duilio Pagano, Giovanni Scianna, Giovan Battista Vizzini, Davide Cintorino, Marco Spada, Francesco Basile, Bruno Gridelli

Research output: Contribution to journalArticlepeer-review


Aim: We aimed to determine whether education level and socioeconomic status in a cohort of liver transplant recipients in the south of Italy were potential predictors of graft and patient survival. Methods: This retrospective study included 221 liver transplant recipients at Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione between January 2006 and September 2009. Donor gender and age, cold ischaemic time, extended criteria donors, recipient age, gender, body mass index, primary aetiology, Model for End-Stage Liver Disease score, co-morbidities, patient health score assessed on the basis of clinical follow-up, highest level of education achieved, and socioeconomic status were collected and analysed. Results: Kaplan-Meier analysis of survival measured by education level and socioeconomic status showed a higher survival rate in patients with higher education level (p=0.04) and socioeconomic status (p=0.01). After adjusting for all covariables, results of the multivariate Cox regression analyses showed that only socioeconomic status remained an independent and significant predictor of overall survival (Hazard Ratio = 0.16, p=0.03). Conclusion: Patient survival after liver transplantation was influenced by low income, low educational level, and lack of access to quality health care. Prospective clinical studies are necessary to fully identify the impact of socioeconomic status on long-term health outcomes, and to propose an evidence-based guide to clinical intervention.

Original languageEnglish
Pages (from-to)893-898
Number of pages6
JournalDigestive and Liver Disease
Issue number11
Publication statusPublished - Nov 2011


  • Complications
  • Liver transplantation
  • Outcome
  • Socioeconomic status

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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