Background Due to demand-supply imbalance in liver transplantation (LT), LT candidates may die before transplantation. Objective Detection of prevalence and predictors of mortality in LT candidates.

In this 4 years cohort study, 544 adult LT candidates were followed in 3 months intervals. Data analysis was performed in Nutritionist, SPSS and R software using Kaplan-Meier, Cox proportional hazard (HRc) and LASSO Cox regression hazard (HRL) tests.

Mean age of patients was 46.7±13.7 years, mostly were male (336; 61.7%). Finally, 414 (76.1%) were alive and 130 (23.9%) dead, while 33.1%, 57.7% and 79.2% of deaths were occurred in the first 3, 6 and 12 months of waiting period. Hepatopulmonary syndrome (HRC=4.7, HRL=1.8), myocardial infarction (MI) (HRC=3.3, HRL=1.6) and low carbohydrate (CHO) diet (HRC=2.7, HRL=1.5) showed strong association with mortality of patients. MELD score, CA 125, high PMN count, weight loss, high level of ALT, positive HBV markers, high MCV of RBCs, ascites, edema of gall bladder wall, high BUN and psychological problems showed also significant association with death in LT candidates

About one fourth of LT candidates die before transplantation. Besides MELD score, HPS, MI, malnutrition and psychological problems of patients should also be managed in these patients.