ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2021
Center variation in long-term outcomes for socioeconomically deprived children.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Material economic hardships are associated with second-year hospitalizations after pediatric liver transplantation: Results from the SOCIAL-Tx study.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- Coproducing a health advocate intervention for pediatric liver transplant recipients using a human-centered design.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Article
- The influence of neighborhood income on healthcare utilization in pediatric liver transplant.Journal of pediatric gastroenterology and nutrition · 2024Article
- Subspecialty Pediatrics: An Unmet Opportunity to Address Unmet Social Risks.Academic pediatrics · 2024Review
- Neighborhood Income Is Associated with Health Care Use in Pediatric Short Bowel Syndrome.The Journal of pediatrics · 2024Article
- Association of state Medicaid expansion policies with pediatric liver transplant outcomes.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- The impact of socioeconomic deprivation on liver transplantation.Frontiers in transplantation · 2024Review
- Can non-directed living liver donation help improve access to grafts and correct socioeconomic disparities in pediatric liver transplantation?Pediatric transplantation · 2023Article
- Association of Primary Care Shortage Areas with Adverse Outcomes after Pediatric Liver Transplant.The Journal of pediatrics · 2022Observational
- Addressing Social Adversity to Improve Outcomes for Children After Liver Transplant.Hepatology (Baltimore, Md.) · 2021Article
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Authors and funding
8 authors.
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Abstract
Neighborhood socioeconomic deprivation is associated with adverse outcomes after pediatric liver transplant. We sought to determine if this relationship varies by transplant center. Using SRTR, we included patients <18 years transplanted 2008-2013 (N = 2804). We matched patient ZIP codes to a deprivation index (range [0,1]; higher values indicate increased socioeconomic deprivation). A center-level patient-mix deprivation index was defined by the distribution of patient-level deprivation. Centers (n = 66) were classified as high or low deprivation if their patient-mix deprivation index was above or below the median across centers. Center quality was classified as low or high graft failure if graft survival rates were better or worse than the overall 10-year graft survival rate. Primary outcome was patient-level graft survival. We used random-effect Cox models to evaluate center-level covariates on graft failure. We modeled center quality using stratified Cox models. In multivariate analysis, each 0.1 increase in the patient-mix deprivation index was associated with increased hazard of graft failure (HR 1.32; 95%CI: 1.05, 1.66). When stratified by center quality, patient-mix deprivation was no longer significant (HR 1.07, 95%CI: 0.89, 1.28). Some transplant centers care for predominantly high deprivation children and maintain excellent outcomes. Revealing and replicating these centers' practice patterns should enable more equitable outcomes.
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