title: Risk factors for impaired quality of life and psychosocial adjustment after pediatric heart, kidney, and liver transplantation.
abstract: Few studies compare HRQOL and PSA in children who have undergone different types of solid organ Tx. In this cross-sectional study, HRQOL and PSA were assessed in 74 Tx patients (16 heart, 44 kidney, 14 liver) at a mean age of 11.5 (range 6.3-16.7), 7.2 yr post-Tx (range 1.0-15.0). HRQOL was self-assessed using standardized health utility questionnaires (15D-17D). The patients' PSA was evaluated using the Child Behavior Checklist for parents, Youth Self-Report for patients aged 11-16 yr, and Teacher Report Form. Outcomes did not differ significantly between Tx groups. Preadolescents (8-11 yr) reported poorer HRQOL compared with same-age peers (p = 0.020). In contrast, adolescents reported similar HRQOL and PSA compared to the general population. Proxy-reports revealed more PSA problems compared with age expectations (p < 0.01), mainly in internalizing behavior (p < 0.01). Lower HRQOL was associated with shorter follow-up time since Tx, congenital disease, and a psychiatric or neurological diagnosis. PSA problems were associated with family-related variables, neurological diagnosis, shorter follow-up time, and in teacher-reports longer disease duration before Tx. Different pediatric Tx groups have similar outcome. Neurological comorbidity and shorter follow-up time are important risk factors, but the impact of family-related variables on PSA indicate the need of family interventions.
authors: Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland. anu.haavisto@helsinki.fi
authors: Anu
authors: A
authors: Haavisto
authors: Marit
authors: M
authors: Korkman
authors: Harri
authors: H
authors: Sintonen
authors: Christer
authors: C
authors: Holmberg
authors: Hannu
authors: H
authors: Jalanko
authors: Jari
authors: J
authors: Lipsanen
authors: Erik
authors: E
authors: Qvist
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology*; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D010290:Parents; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome