Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;27(1):e14418.
doi: 10.1111/petr.14418. Epub 2022 Nov 1.

A systematic review of social determinants of health in pediatric organ transplant outcomes

Kelly E Rea  1 , Kara B West  2 , Anna Dorste  3 , Elizabeth S Christofferson  4 , Debra Lefkowitz  2 , Emily Mudd  5 , Lauren Schneider  6 , Courtney Smith  7 , Kelli N Triplett  8 , Kristine McKenna  9
Affiliations

A systematic review of social determinants of health in pediatric organ transplant outcomes

Kelly E Rea et al. Pediatr Transplant. 2023 Feb.

Abstract

Background: Equitable access to pediatric organ transplantation is critical, although risk factors negatively impacting pre- and post-transplant outcomes remain. No synthesis of the literature on SDoH within the pediatric organ transplant population has been conducted; thus, the current systematic review summarizes findings to date assessing SDoH in the evaluation, listing, and post-transplant periods.

Methods: Literature searches were conducted in Web of Science, Embase, PubMed, and Cumulative Index to Nursing and Allied Health Literature databases.

Results: Ninety-three studies were included based on pre-established criteria and were reviewed for main findings and study quality. Findings consistently demonstrated disparities in key transplant outcomes based on racial or ethnic identity, including timing and likelihood of transplant, and rates of rejection, graft failure, and mortality. Although less frequently assessed, variations in outcomes based on geography were also noted, while findings related to insurance or SES were inconsistent.

Conclusion: This review underscores the persistence of SDoH and disparity in equitable transplant outcomes and discusses the importance of individual and systems-level change to reduce such disparities.

Keywords: disparity; pediatric organ transplantation; social determinants of health.

PubMed Disclaimer

References

REFERENCES

    1. Racial bias in clinical tools and impact on organ transplantation. Published online April 21, 2021. Accessed February 25, 2022. https://www.myast.org/sites/default/files/Racial%20Bias%20in%20Clinical%...
    1. Social determinants of health - healthy people 2030|health.Gov. Accessed February 25, 2022. https://health.gov/healthypeople/objectives-and-data/social-determinants...
    1. Bramer WM, Rethlefsen ML, Mast F, Kleijnen J. Evaluation of a new method for librarian-mediated literature searches for systematic reviews. Res Synth Methods. 2018;9(4):510-520.
    1. National Institute of Health National Heart, Lung, and Blood Institute. Study quality assessment tools: quality assessment tool for observational cohort and cross-sectional studies. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
    1. American Psychological Association. Inclusive Language Guidelines. Published 2021. Accessed February 15, 2022. https://www.apa.org/about/apa/equity-diversity-inclusion/language-guidel...

Publication types

LinkOut - more resources