JMIR Publications

ABSTRACT

Background:

Liver transplant candidates and recipients require continuous care throughout the transplant trajectory, including pretransplant prehabilitation and long-term posttransplant management. Conventional care models are constrained by time, distance, and limited health care resources and may therefore be insufficient to meet patients’ needs across the continuum of care. Digital health technologies offer new approaches to remote care delivery and self-management support in liver transplantation.

Objective:

This scoping review aimed to map the technological modalities, intervention components, outcome measures, and implementation issues associated with digital health technologies used across the care continuum for adult liver transplant candidates and recipients and to inform the development of specialty-specific digital continuity-of-care interventions.

Methods:

Nine English- and Chinese-language databases—PubMed, Embase, CINAHL, Web of Science, the Cochrane Library, CNKI (China National Knowledge Infrastructure), Wanfang Data, VIP Database, and SinoMed—were searched from inception through July 10, 2026. Original quantitative, qualitative, and mixed methods studies involving adult liver transplant candidates or recipients and the use of mobile health technologies for care beyond conventional in-person settings were eligible. The review followed the Arksey and O’Malley framework, refined using Joanna Briggs Institute (JBI) methodology for scoping reviews, and was reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines.

Results:

The search identified 7,746 records, and 28 studies were included. Telehealth platforms or remote management systems were used in 24 studies, and remote education was included in 22 studies. Five studies focused on pretransplant/candidacy, 9 on early posttransplant recovery, 4 on long-term survivorship, 8 were cross-stage/mixed, and 2 had unspecified posttransplant timing. No study focused only on the perioperative/inpatient-to-home transition stage. Nine randomized intervention studies were identified. Among these studies, positive findings were more common for medication or treatment adherence, self-management, health behaviors, psychological outcomes, and selected health service outcomes. Results were less consistent for quality of life, physiological outcomes, and functional outcomes. Fifteen studies reported implementation-related outcomes. Reported barriers included limited device access, privacy concerns, limited uptake, and difficulties with sustained engagement.

Conclusions:

Current evidence is concentrated in early posttransplant recovery. Evidence across transplant stages and outcome domains is uneven. Studies focused on the perioperative/inpatient-to-home transition stage are lacking. Future studies should use multicenter designs and standardized outcome measures, include longer follow-up, and evaluate implementation, equitable access, and costs.