We conducted a population-based cohort study of pediatric liver transplantation (LT) in Ontario, Canada, a universal healthcare setting, to quantify survivorship burden relative to matched general-population controls and assess whether socioeconomic status (SES) modified these differences. First, isolated pediatric LTs (1991\u20132021) were linked to provincial administrative data and matched 1:5 on sex and birth year to general-population controls. Outcomes were mortality, chronic conditions, de novo cancers, and live births, with prespecified SES interaction analyses. Among 449 LT recipients and 2,245 controls (median age 1.9 years), 20-year survival was 78%. At 10 years, LT recipients had higher cumulative incidence of mood disorders (16.1% vs 8.77%; IRR 3.61, 95% CI 2.9\u20134.5) and de novo cancer (7.83% vs 0.19%; IRR 25.1, 95% CI 12.1\u201352.0), with cancer excess concentrated in the first 5 years. In a female-only landmark analysis beginning at age 15, live-birth incidence was similar between groups (IRR 0.75, 95% CI 0.39\u20131.44), suggesting childhood LT does not necessarily preclude later family-building. Lower neighborhood income predicted higher post-LT mortality (adjusted HR 2.1, 95% CI 1.2\u20133.7). Despite universal healthcare, socioeconomic disadvantage was associated with worse long-term outcomes; integrating social determinants of health into survivorship care is needed.<\/p>\n","protected":false},"excerpt":{"rendered":"
We conducted a population-based cohort study of pediatric liver transplantation (LT) in Ontario, Canada, a universal healthcare setting, to quantify survivorship burden relative to matched general-population controls and assess whether socioeconomic status (SES) modified these differences. First, isolated pediatric LTs (1991\u20132021) were linked to provincial administrative data and matched 1:5 on sex and birth year […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[20,54,60],"migration-helper-qa-sample-set":[],"class_list":["post-24337","journal_article","type-journal_article","status-publish","hentry","topic-health-and-health-care-inequality","topic-organ-transplantation-and-donation","topic-policy-and-program-evaluation"],"acf":{"citation":"Yodoshi T, Kuenzig ME, Tang F, Saito MK, Zizzo A, Sayed BA, Ng VL, Benchimol EI. Am J Transplant<\/em>. 2026; S1600-6135(26): 02689-4. Epub 2026 Jul 25.","source_url":"https:\/\/doi.org\/10.1016\/j.ajt.2026.07.024","ices_scientist":[21974,1174],"site":[6735],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\n