Objectives In advanced organ failure patients: (1) To study the association between treatment modality versus employment status, (2) To analyze socio-demographic profiles and deprivation status, and (3) To explore Return to Work (RTW) by analysis of self-reported employment status.

Methods This ongoing hospital based cross-sectional study used a convenience sample: 1070 patients with advanced organ failure requiring solid organ transplant (SOT) or dialysis pooled from the Comprehensive Psychosocial Research Data System at UHN, Toronto. Patient reported outcome measures, clinical and socio-demographic variables were collected from stable outpatients on iPads using electronic data capture (DAta Driven Outcomes System-DADOS, Techna Institute, UHN, Toronto). The Ontario Marginalization Index characterized material deprivation. Data was analyzed using STATA v16, logistic regression used multiple imputation by chained equations.

Results Of 1070 SOT recipients, 646 (60%) were males with 424 (40%) females. Almost half (49%) were of White ethnicity, Black (23%) followed by South Asians and East Asians. 63% (646) had >12 years education, the kidney-pancreas sub-group were highest 88% (30) then kidney, liver and dialysis with 65%, 62% and 59%, respectively. 51% of dialysis patients had a yearly income of $70,000. These results reflect the higher employment status of kidney (60%), liver (55%) and kidney-pancreas (51%) transplants compared to dialysis patients (28%). 59% of dialysis patients had high deprivation. The association between treatment modality vs employment status and employment status vs deprivation remained statistically significant after adjusting for age, sex, ethnicity and comorbidities in logistic regression models.

Conclusion SOT was associated with significantly higher odds of employment and lower material deprivation. Dialysis, transplant and occupational health professionals should support SOT and dialysis patients overcoming barriers to maintain and RTW. RTW post-SOT is complex and likely associated with personal, professional, societal and medical factors.