LT rates increased significantly following MELD exception implementation for HCC patients, but it is not clear if this trend has continued in more recent years. The current study evaluates trends in LT utilization among transplant-eligible HCC patients in the recent era. Methods: HCC patients identified from the SEER 1998–2010 registry were analyzed by time periods: post-MELD

2009–2010 vs. post-MELD 2004–2008 vs. pre-MELD 1998–2003. The 2003 cut-off was used to account for lag-time in the effect of MELD implementation in late 2002. Results: Overall, HCC patients were more likely to be men (74.6% in 2009–2010 vs. 73.4% in 2004–2008 vs. 70.6% in 1998–2003). With increasing time periods, the proportion of localized HCC increased (45.0% vs. 50.4% vs. 51.7%, p<0.001), whereas advanced HCC decreased. While the proportion of HCC within Milan criteria MI-503 also increased with time (22.8% vs. 31.8% vs. 37.1%, p<0.001), the proportion of these patients receiving LT

increased from 1 998–2003 to 2004–2008, but decreased in 2009–2010 www.selleckchem.com/products/BIBW2992.html even in those with more favorable characteristics (localized HCC within Milan criteria, age <70), though the number of transplants per year were similar in 2004–2008 and 2009–2010 (Figure). Multivariate logistic regression, inclusive of sex, age, ethnicity, Milan criteria, tumor stage, tumor size and number, and time periods, demonstrated a lower likelihood of LT in 2009–2010 compared to 1998–2003 (OR 0.63, 95% CI 0.57–0.71, p<0.001). Blacks (OR 0.48, 95% CI 0.41–0.56, p<0.001), Asians (OR 0.65, 95% CI 0.57–0.73, p<0.001), and Hispanics (OR 0.76, 95% CI 0.68–0.85, p<0.001) were less likely to receive LT. Conclusion: Despite increasing rates of earlier staged

HCC diagnosed within Milan criteria, rates of LT are declining in the recent era (2009–2010). HCC patients in 2009–2010 and ethnic minorities were significantly less likely to receive LT. Disclosures: find more Aijaz Ahmed – Consulting: BMS, Gilead, Vertex, Genentech, Onyxx Mindie H. Nguyen – Consulting: Gilead Sciences, Inc., Bristol-Myers Squibb, Bayer AG; Grant/Research Support: Gilead Sciences, Inc., Bristol-Myers Squibb, Novartis Pharmaceuticals, Roche Pharma AG The following people have nothing to disclose: Robert Wong, Pardha Devaki, Long H. Nguyen, Ramsey Cheung Background: Hepatology guidelines and other published data regarding inpatient cirrhosis care (e.g. ascites, variceal bleed management) may have led to better outcomes in the last 10 years. Aim: We aimed to examine inpatient mortality for cirrhotic patients over time and correlate trends with patient and care variables. Methods: The Healthcare Cost & Utilization Project, National Inpatient Sample (HCUP NIS) is a large inpatient database gathering data from >1000 US hospitals representing a 20% stratified sample from 45 states.