Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
September 18, 2026 · via Europe PMC
Beyond graft survival: Health literacy is associated with patient-reported health after liver transplantation.
Denk D, Alcober-Boquet L, Queck A.
AI summary — for doctors, generated from the abstract only
In a large US cross-sectional study, over a third of liver transplant recipients had marginal or low health literacy, and better health literacy was strongly associated with better patient-reported physical and mental health, independent of graft survival.
What was studied
A large-scale cross-sectional analysis using the U.S. All of Us Research Program, examining 1042 adults with documented liver transplantation who completed the 'Overall Health' survey, assessing health literacy (via the 3-item Brief Health Literacy Screen) and its association with patient-reported physical and mental health (PROMIS Global Health T-scores), with comparisons to adults with cirrhosis without transplant and the general study population.
Key findings
- Among 1042 evaluable liver transplant recipients, marginal health literacy (BHLS ≤12) was present in 35.7% (372 recipients), including 12.6% (131) with low health literacy (BHLS ≤9); transplant recipients had lower mean health literacy (12.8) than the general All of Us population (13.4) but higher than adults with cirrhosis without transplant (12.4, all p<0.001).
- Each 3-point increase in health literacy score was associated with a 3.22-point higher Physical Health T-score (95% CI 2.52-3.92) and a 2.85-point higher Mental Health T-score (95% CI 2.09-3.60) after adjustment for age, sex, race/ethnicity, and education (both p<0.001).
- The strength of the health literacy-health outcome association did not differ significantly between transplant recipients and the comparator groups.
Clinical relevance
The findings suggest that health literacy is a modifiable factor independently linked to better patient-reported physical and mental health after liver transplantation, supporting routine assessment of health literacy as part of long-term post-transplant care and potentially identifying patients who could benefit from targeted health education support.
Who should care
Limitations
This is a cross-sectional study, so it cannot establish whether improving health literacy causes better health outcomes, only that the two are associated.
Over a third of liver transplant recipients in this large US study had marginal or low health literacy, which was strongly linked to worse patient-reported physical and mental health, suggesting health literacy assessment should be part of post-transplant care.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Current liver transplantation (LT) guidelines recognize perceived health-related quality of life as an important outcome of long-term care, yet it remains unclear whether post-transplantation health literacy plays a role in patient-reported physical and mental health. We conducted a large-scale cross-sectional analysis using data from the U.S. All of Us Research Program of adults with documented LT before completing the "Overall Health" survey (n=1,042). Health literacy was assessed with the 3-item Brief Health Literacy Screen (BHLS; range, 3-15), and physical and mental health with PROMIS Global Health T-scores. Multivariable linear regression adjusted for age, sex at birth, race and ethnicity, and education. Associations were compared with those in adults with cirrhosis without LT (n=5,290) and the general All of Us comparator population. Among 747,029 participants, 1,042 LT recipients had evaluable BHLS scores. Marginal health literacy (BHLS ≤12) was present in 372 recipients (35.7%), including 131 (12.6%) with low health literacy (BHLS ≤9). LT patients displayed a lower health literacy compared to the general population (mean BHLS 12.8 vs. 13.4), but higher than adults with cirrhosis (12.4; all p<0.001). Each 3-point BHLS score increase associated with 3.22-point higher Physical Health (95% CI, 2.52-3.92) and 2.85-point higher Mental Health T-scores (95% CI, 2.09-3.60) after adjustment (both p<0.001). The strength of the association did not differ significantly between recipients and either comparator group. Transplant recipients displayed reduced health literacy, and post-transplant health literacy was strongly associated with better patient-reported physical and mental health. These findings identify health literacy as a modifiable dimension of long-term transplant survivorship and support its assessment in post-transplant care.
DOI
10.1097/lvt.0000000000001001
PMID
42758892
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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