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Background and Aims Evaluating patients for liver transplantation (LT) involves multiple investigations, specialist input and MDT discussion to determine candidacy. Correctly identifying suitable candidates allows efficient and cost-effective use of LT work up resources. Allied health professional assessments offer objective measures to assess LT risk and inform candidacy.Method In our centre, all potential LT candidates are initially discussed in principle (DIP) by the LT MDT. Patients deemed higher risk undergo pre-screening in a Multidisciplinary Assessment Clinic (MAC), receiving input from dietetics, physiotherapy, and specialist alcohol nurse to determine suitability for formal work-up. Patients perceived more favourably after DIP proceed directly to LT work-up.We reviewed all patients who underwent a formal LT work-up (excluding ALF and ACLF) over a 12-month period (June 2022 – May 2023). We compared those evaluated in the MAC prior to work-up with those who went directly to work-up.Results Of 144 patients undergoing formal LT work-up, median age was 56 (range 27–71), with 34% female. Indications included decompensated chronic liver disease (74%), HCC (13%), and variant syndrome (13%). Forty patients (28%) were seen in the MAC before LT work-up, while 104 went directly to LT work-up. Alcohol aetiology was significantly higher in the MAC group (58% vs. 22%, p<0.01). However, clinical decompensation, UKELD score, and age were similar between groups.Following work-up, 83% (33/40) of MAC patients were ultimately listed, with 65% listed within a month. The remaining 8 were listed with a median delay of 2 months. In contrast, only 64% (67/104) of direct work-up patients were listed, with 50% listed within a month. The remining 16 patients were listed with a median delay of 2 months. Patients evaluated in the MAC were statistically more likely to be listed (33/40 vs 67/104, p=0.04), despite initially being identified as less favourable candidates.Of the 44 patients who underwent work-up but were never listed, only 16% came from the MAC group, compared to 84% from the direct work-up group. Common reasons for decline included frailty, alcohol risk, and medical contraindications.Conclusion These data suggest that LT work-up slots are used more efficiently by patients evaluated in a MAC, leading to significantly higher proportion of timely listings. Pre-screening patients in a MAC can help avoid costly, futile LT work-ups. While 64% of the direct work-up group were still listed, indicating a subset can bypass MAC, our data did not identify clear predictive markers for direct selection.