Introduction: There is currently no data to guide care of transgender and gender non-conforming (TGNC) individuals after liver transplant (LVT), making it difficult to give this population high quality recommendations. Our aim was to improve understanding of the TGNC LVT population at Children’s Hospital Los Angeles (CHLA).

Methods: We performed a retrospective chart review of 330 current CHLA LVT patients to identify TGNC individuals. Inclusion criteria were: (1) LVT recipient (2) current CHLA LVT clinic patient and (3) TGNC identification in most recent LVT clinic or hospitalization note. For included patients, we reviewed all LVT, adolescent, psychology, and psychiatry clinic and inpatient notes for information on LVT and transgender care.

Results: We identified four TGNC LVT patients at CHLA (Table 1). All have had LVT-related complications. Three patients expressed interest in gender affirming care, but only two established care with adolescent medicine. One patient started hormone therapy and underwent breast reduction surgery without liver enzyme changes while three patients have not expressed interest in gender affirming medications or surgeries. Three patients have mental health diagnoses and are in therapy.

Discussion: Our preliminary findings suggest TGNC LVT patients have complex medical needs beyond that of standard LVT patients. As the number of individuals who identify as TGNC is rising, LVT providers must expand care for this population. Each pediatric LVT center has only a small number of TGNC LVT patients, so we are working on a multi-center retrospective study to more thoroughly build on knowledge of and treatment for this population.