{"doi":"10.1016/j.jtct.2023.04.020","title":"The Transplantation Ecosystem: A New Concept to Improve Access and Outcomes for Older Allogeneic Hematopoietic Cell Transplantation Patients","abstract":null,"journal":"Transplantation and Cellular Therapy","year":2023,"id":616940,"datarank":0.6809937038526188,"base_score":2.5649493574615367,"endowment":2.5649493574615367,"self_citation_contribution":0.38474240361923057,"citation_network_contribution":0.2962513002333882,"self_endowment_contribution":0.38474240361923057,"citer_contribution":0.2962513002333882,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":6,"citers_with_citation_signal":5,"citers_with_endowment":5,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1590774,"name":"Rebecca Olin","orcid":null,"position":1,"is_corresponding":false},{"id":284263,"name":"Vijaya Raj Bhatt","orcid":"0000-0003-2513-0533","position":2,"is_corresponding":false},{"id":122962,"name":"Saurabh Chhabra","orcid":"0000-0001-9117-8696","position":3,"is_corresponding":false},{"id":749760,"name":"Pashna N. 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The importance of patient fitness, a well-matched donor, and disease control to the success of allogeneic HCT have been well documented; however, these factors fail to account for the impact of the complex transplantation ecosystem (TE) that older adult HCT candidates must navigate. We propose a definition of the TE modeled after the social determinants of health. Furthermore, we outline a research agenda aimed at increasing understanding of the roles of individual social determinants of transplantation health in the larger ecosystem and how they may benefit or harm older adult HCT candidates. Herein we define the TE and its individual tenets, the social determinants of transplantation health. We review the available literature while incorporating the expertise of the membership of the American Society for Transplantation and Cellular Therapy (ASTCT) Special Interest Group for Aging. The membership of the ASTCT Special Interest Group for Aging identify knowledge gaps and strategies to address them for each of the described social determinants of transplantation health. The ecosystem is an essential but underappreciated pillar for transplant access and success. We put forth this novel research agenda seeking to gain a better understanding of the complexity of HCT in older adults and develop strategies to improve access to HCT, survival, and quality of life.","is_dataset_classified":null,"base_score":2.5649493574615367,"endowment":2.5649493574615367,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"37137442","pmcid":null,"openalex_id":"https://openalex.org/W4367609921","authors":[],"funders":[{"funder_name":"NCI NIH HHS","grant_id":"P30 CA008748","title":null}],"total_grants":1,"fwci":2.2045,"citation_percentile":0.88387978,"influential_citations":0,"citation_trend":[{"year":2023,"count":2},{"year":2024,"count":4},{"year":2025,"count":6}],"oa_status":"closed","license":"http://creativecommons.org/licenses/by-nc-nd/4.0/","oa_locations":[{"url":"https://api.elsevier.com/content/article/PII:S2666636723012587?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S2666636723012587?httpAccept=text/plain","host_type":"publisher"},{"url":"https://doi.org/10.1016/j.jtct.2023.04.020","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/37137442","host_type":"repository"}],"fields_of_study":["Hematopoietic Stem Cell Transplantation","Acute Lymphoblastic Leukemia research","Childhood Cancer Survivors' Quality of Life"],"mesh_terms":["Aged","Humans","Quality of Life","Transplantation, Homologous","Ecosystem","Hematopoietic Stem Cell Transplantation","Hematologic Neoplasms"],"keywords":["Transplantation","Quality of life (healthcare)","Disease","Medicine","Harm","Hematopoietic cell","Gerontology","Intensive care medicine","Psychology","Haematopoiesis","Stem cell","Internal medicine","Biology","Social psychology","Nursing","Elderly","Geriatric","Supportive Care","Older Adults","Allogeneic Hematopoietic Cell Transplantation","Transplantation Ecosystem"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T00:26:06.560846Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}