Factors contributing to employment patterns after liver transplantation.
Many liver transplant recipients return to work, but their patterns of employment are unclear. We examine patterns of employment 5 years after liver transplantation.



First-time liver transplant recipients ages 18-60 years transplanted from 2002 to 2009 and surviving at least 5 years were identified in the United Network for Organ Sharing registry. Recipients' post-transplant employment status was classified as follows: (i) never employed; (ii) returned to work within 2 years and remained employed (continuous employment); (iii) returned to work within 2 years, but was subsequently unemployed (intermittent employment); or (iv) returned to work ≥3 years post-transplant (delayed employment).



Of 28 306 liver recipients identified during the study period, 12 998 survived at least 5 years and contributed at least 1 follow-up of employment status. A minority of patients (4654; 36%) were never employed, while 3780 (29%) were continuously employed, 3027 (23%) were intermittently employed, and 1537 (12%) had delayed employment. In multivariable logistic regression analysis, predictors of intermittent and delayed employment included lower socioeconomic status, higher local unemployment rates, and post-transplant comorbidities or complications.



Never, intermittent, and delayed employment are common after liver transplantation. Socioeconomic and labor market characteristics may add to clinical factors that limit liver transplant recipients' continuous employment.
The Department of General Surgery, Division of Transplantation, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Eliza W
0000-0003-2191-6811
EW
Beal
The Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Dmitry
D
Tumin
The Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Khalid
K
Mumtaz
The Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA.
Michael
M
Nau
The Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Joseph D
JD
Tobias
The Department of Internal Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Don
D
Hayes
The Department of General Surgery, Division of Transplantation, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Kenneth
K
Washburn
The Department of General Surgery, Division of Transplantation, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Sylvester M
SM
Black
D000293:Adolescent; D000328:Adult; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data*; D055815:Young Adult
employment; liver transplantation; unemployment