https://pubmed.ncbi.nlm.nih.gov/34320247/liver transplantation
Hepatology. 2021 Jul 28.
doi: 10.1002/hep.32073. Online ahead of print.

Addressing social adversity to improve outcomes for children after liver transplant

Sharad I Wadhwani 1, Laura Gottlieb 1, John C Bucuvalas 2 3, Courtney Lyles 1, Jennifer C Lai 1

Abstract

The social determinants of health, defined as the conditions in which we live, learn, work, and play, undoubtedly impact health outcomes. Social adversity in childhood perpetuates over the life course and has consequences extending into adulthood. This link between social adversity and adverse outcomes extends to children undergoing liver transplant, with children from socioeconomically deprived neighborhoods experiencing a greater burden of morbidity and mortality after transplant. Yet, we lack an in-depth understanding of how to address social adversity for these children. Herein, we lay out a strategy to develop and test interventions to address social adversity for children undergoing liver transplant. To do so, we believe that more granular data on how specific social risk factors (e.g., food insecurity) impact outcomes for children after liver transplant. This will provide the liver transplant community with knowledge on the most pressing problems to address. Then, using the National Academies of Sciences, Engineering, and Medicine framework for integrating social needs into medical care, the health system can start to develop and test health system interventions. We believe that attending to our patients' social adversity will realize improved outcomes for children undergoing liver transplant.