Impact of social determinants of health on post-liver transplant outcomes

• Examines how social determinants influence post-liver transplant outcomes • Identifies key drivers: literacy, economics, geography, and social support • Highlights inequities linked to socioeconomic and racial disparities • Integrates policy and institutional factors into SDoH framework • Recommends multi-level interventions to improve post-transplant equity Liver transplantation (LT) can significantly improve survival and quality of life for patients with end-stage liver disease however, post-LT outcomes are impacted by environmental factors beyond medical care. This review explores the impact of Social Determinants of Health (SDoH) on post-LT outcomes by using the five pillars of SDOH derived from the Healthy People 2030 framework: education access and quality, economic stability, healthcare access, neighborhood and build environment, and social and community context. The existing literature highlights that low health literacy, socioeconomic disparities, insurance type, and geographic disparities contribute to higher rates of mortality, graft loss and non-adherence to immunosuppression. Geographic areas located in food deserts, limited access to primary care physicians, physical therapy and mental health support can further impact graft survival. Addressing these factors through improved education, equitable healthcare access and sustained insurance coverage is essential for achieving optimal post-LT outcomes.