Depression Management, Resource Utilization and Outcomes Following Liver Transplant. Abstract# 1497

Background: There is robust evidence that new onset depression after liver transplant (LTX) is associated with increased morbidity and mortality. Yet, there is paucity in the data analyzing the effect of depression treatment on LTX outcomes. The aim of this study was to determine if depression treatment influences outcomes after LTX. Methods: Single-center, longitudinal cohort study of LTX patients from Oct 2010-June 2013. Exclusions were pediatrics, prisoners, and pregnancy. Depression diagnosis was based on PMH and documentation from psychosocial providers. Patients were separated into 3 groups for analysis: no depression, adequately treated depression, and inadequately treated depression. Depression was considered adequately treated if the Antidepressant Treatment History Form was >3. Results: 161 patients were included in the analysis; 103 without depression, 24 with adequately treated depression and 34 with inadequately treated depression. Baseline characteristics were similar. Patients with inadequately treated depression had significantly more encounters with a healthcare provider and numerically more complications after LTX, including those requiring readmission or requiring outpatient interventions (Table 1). Graft loss tended to be higher in these patients (Figure 1). The adequately treated depression group was more likely to be on antidepressants at 30 and 60 days post-LTX (Table 1). The inadequately treated group was significantly more likely to be on a sleep aid 30 days post-LTX (p=0.014). Benzodiazepine and opioid use were similar between groups. Conclusion: Inadequately treated depression leads to increased healthcare resource utilization in LTX. Patients with adequately treated depression have similar outcomes as those without depression. Use of sleep aids early post-LTX may be a surrogate indicator of inadequately treated depression. (Figure Presented).