Psychosocial outcome and resilience after paediatric liver transplantation in young adults

Clin Res Hepatol Gastroenterol. 2019 Apr;43(2):155-160. doi: 10.1016/j.clinre.2018.08.017. Epub 2019 Feb 5.

Abstract

Background and objective: The long-term psychosocial outcome of young adults after paediatric liver transplantation (LT) was investigated with the focus on day-to-day living. We aimed to capture patients' subjective perceptions of well-being and autonomy based on key physical outcome parameters.

Methods: All patients following paediatric LT at Hannover Medical School born before 2002 with a post-transplant follow-up of at least four years were included in this study. This retrospective observational study compared psychosocial parameters obtained from a self-designed 77-item questionnaire with standard clinical outcome variables.

Results: Eighty-two patients (male: 57%) aged 13-41 years were included in the survey within a three-month period (response rate: 41%). With an adherence rate of 33%, all but two patients were immunosuppressed. In total, 53 patients had transitioned to adult care largely without problems. Eighty-three percent (n = 68) evaluated their current health status as "(very) good". Sixty-seven patients (82%) did not experience health-related anxiety in daily life.

Conclusions: Our results demonstrate psychological stability and high self-esteem of young patients, as well as good integration into society and a high degree of normality during daily life after LT. Adherence rates are lower than anticipated and do not correlate with patients' understanding of their medical condition.

Keywords: Adherence; Liver transplantation; Paediatric; Psychosocial outcome; Quality of life; Transition.

Publication types

  • Observational Study

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Age Factors
  • Anxiety / epidemiology
  • Child
  • Female
  • Follow-Up Studies
  • Health Status*
  • Health Surveys / statistics & numerical data
  • Humans
  • Immunocompromised Host
  • Liver Transplantation / psychology*
  • Liver Transplantation / statistics & numerical data
  • Male
  • Resilience, Psychological*
  • Retrospective Studies
  • Self Concept
  • Transition to Adult Care / statistics & numerical data
  • Young Adult