Health status in young adults two decades after pediatric liver transplantation

S. Mohammad*, L. Hormaza, K. Neighbors, P. Boone, M. Tierney, R. K. Azzam, Z. Butt, E. M. Alonso

*Corresponding author for this work

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

We conducted a cross-sectional study of patients who underwent pediatric liver transplant (LT) between 1988 and 1992 to evaluate long-term health status. Survivors completed socio-demographic, medical and Health-Related Quality of Life (HRQOL) surveys by mail including the SF-36v2, PedsQL™4.0 Generic Core Scale, PedsQL™ Cognitive Functioning Scale and PedsQL™3.0 Transplant Module. SF-36 scores were converted to SF6D-based utilities and risk factors for lower outcomes were assessed. Eighty-five of 171 patients had survived. Fifty-six were contacted with a response rate of 66%. Median age at LT was 0.86 years (IQR 0.58-3.0) and 64.3% had biliary atresia. Mean age at survey was 23.0 ± 4.4 years: 62% attended college, 68% lived with parents and 80% of those over 23 were employed. Patient health utilities were lower than norms (0.75 ± 0.12 vs. 0.82 ± 0.18, p < 0.01) and correlated with unemployment (p < 0.042), hospitalizations (p < 0.005) and lower education level (p < 0.016). Lower PedsQL™3.0 Transplant Module and PedsQL™ 4.0 Generic Core Scale scores correlated with unemployment (p = 0.006, p = 0.009) and hospitalizations (p = 0.006, p = 0.02). Pediatric transplant recipients who survive to adulthood have lower physical HRQOL, measurable transplant-related disability and lower health utility. Transplantation is life saving; however, physical and psychological sequelae continue to affect health status up to two decades later. In a survey of long-term survivors of pediatric liver transplantation, the authors discover that despite significant comorbidities, lower physical quality of life and lower than expected health utilities, recipients' overall quality of life, employment status and attainment of higher education are comparable to their healthy peers. See editorial by McDiarmid on page 1367.

Original languageEnglish (US)
Pages (from-to)1486-1495
Number of pages10
JournalAmerican Journal of Transplantation
Volume12
Issue number6
DOIs
StatePublished - Jun 1 2012

Keywords

  • Health-Related Quality of Life
  • health utilities
  • outcomes
  • pediatric liver transplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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