ArticleTransplant immunology2024
Structural social determinants of health as barriers to liver transplant waitlisting.
Article in Transplant immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A scoping review of the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) for use with liver transplant candidates.BioPsychoSocial medicine · 2026Review
- Alcohol Relapse After Liver Transplantation: Advances in Risk Stratification, Biomarker Integration, and Post-Transplant Care.Gastro hep advances · 2026Review
- Neighborhood Social Cohesion Associated With Chronic Liver Disease Prevalence and All-Cause Mortality.Gastro hep advances · 2026Article
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Authors and funding
3 authors.
Funding
Abstract
Social determinants of health, both individual and structural, impact access to liver transplantation (LT). We aimed to evaluate the association between structural social determinants of health (SSDoH) and individual-level psychosocial factors (as measured by the Stanford Integrated Psychosocial Assessment for Transplant, SIPAT score) on failure to waitlist for LT. We conducted a single-center retrospective cohort study of 2762 patients evaluated for LT. SSDoH exposures included the Social Deprivation Index (SDI), the proportion of households on cash public assistance or supplemental nutrition assistance (% public assistance), and distance to the transplant center. Neighborhood SDI score in the highest quartile (OR 1.32, 95 % CI 1.07-1.63) and % on public assistance in the highest quartile (OR 1.41, 95 % CI 1.14-1.75) were associated with increased odds of not being waitlisted for LT. These associations remained significant after adjusting for individual psychosocial risk using SIPAT scores (≥21, high psychosocial risk). Highest quartile neighborhood SDI (OR 1.70, 95 % CI 1.13-2.54) and the highest quartile of % on public assistance (OR 1.67, 95 % CI 1.11-2.53) were also associated with increased odds of failure to waitlist for psychosocial reasons. However, these associations were no longer significant after adjusting for individual SIPAT scores. High-risk SIPAT scores were more prevalent in neighborhoods with the highest quartile of SSDoH measures. Transplant centers can design initiatives to build individual psychosocial support to mitigate the impact of structural barriers.
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