Evidence map›Paper›PMID 42467992›Full record

Trial reportHepatology communications2026

Health advocates to address social adversity in pediatric liver transplantation: A clinical trial.

Sharad I Wadhwani, Bethany Reyna, Andrea Huerta, John C Bucuvalas, Laura M Gottlieb, Catherine Lee, Courtney R Lyles, Sue J Rhee, Amy M Shui, Jennifer C Lai

Registry-linked trialAbstract readClinical Trial
In one paragraph

Trial report in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05700799 (HEalth Advocate for Liver Transplant - Pilot), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05700799 nacompletednot on this map

HEalth Advocate for Liver Transplant - Pilot

TypeinterventionalSponsorUniversity of California, San FranciscoRan2023 to 2026Enrolled15ConditionsLiver Transplant, ComplicationsArmsHealth Advocate
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sharad I WadhwaniDepartment of Pediatrics, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0001-5565-6670
Bethany ReynaDepartment of Pediatrics, University of California San Francisco, San Francisco, California, USA.
Andrea HuertaDepartment of Pediatrics, University of California San Francisco, San Francisco, California, USA.
John C BucuvalasDepartment of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID 0000-0002-6767-8874
Laura M GottliebDepartment of Family & Community Medicine, University of California San Francisco, California, USA.
Catherine LeeDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Courtney R LylesCenter for Healthcare Policy & Research, University of California Davis, Davis, California, USA.
Sue J RheeDepartment of Pediatrics, University of California San Francisco, San Francisco, California, USA.
Amy M ShuiDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Jennifer C LaiDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0003-2092-6380

Funding

UCSF Liver Core CenterP30DK026743 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jennifer Y. Chen · 1986 to 2026
$30.7M
Addressing social adversity to improve outcomes among children undergoing liver transplant: the role for a health advocate on the transplant teamK23DK132454 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI WADHWANI, SHARAD · 2022 to 2025
$860k
NIDDK NIH HHS K23 DK132454NIDDK NIH HHS P30 DK026743
6 · The paper itself

Abstract

backgroundChildren undergoing liver transplantation experience socioeconomic disparities in long-term outcomes, partly due to unaddressed material economic hardships such as food insecurity and housing instability. Health Advocates-trained lay health workers who assist families in navigating social and medical systems-may mitigate these disparities. We pilot-tested a Health Advocate intervention (NCT05700799) to assess feasibility, acceptability, and preliminary effects on caregiver experience and clinical outcomes in pediatric liver transplant recipients.

methodsIn this single-center study, 18 caregivers/child dyads participated in a 90-day Health Advocate program; they were provided weekly support from trained navigators. Navigators helped to identify and connect participants with community-based resources and communicated reported social risks to the transplant team.

resultsThe patients' median age at transplant was 1.1 (0.7, 4.6) and the median age at study enrollment was 8.6 (4.3, 13.1) years; 83% remained in the intervention until their needs were met or the end of the 12-week intervention. Caregivers reported improvement in comfort discussing social risks with the transplant team and improved overall care experience (both median 1-point change). Clinical parameters, including the Medication Level Variability Index, trended toward improvements. Qualitative analysis demonstrated high enthusiasm for the intervention, with themes of enhanced communication, reduced stress, and practical assistance addressing diverse social needs.

conclusionsA Health Advocate intervention for pediatric liver transplant families was feasible, acceptable, and associated with improved caregiver experiences. These preliminary findings support testing this intervention in a multi-center effectiveness and implementation trial to evaluate its impact on improving longer-term transplant outcomes.

Indexed as

Liver TransplantationAdolescentCaregiversChildChild, PreschoolFeasibility StudiesFemaleHumansInfantMalePilot Projectsintervention researchliver transplant outcomespediatricssocial adversitysocial determinants of heath

Identifiers

PMID42467992
PMCPMC13671608

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.