Introduction Anxiety symptoms influence health outcomes in pediatric organ transplant recipients. Assessing the quality of anxiety scales is critical to address the psychological challenges these patients face. Variability in how anxiety is conceptualized across scales highlights the need for selecting appropriate instruments. Objective This systematic review aimed to search and synthesize anxiety scales used in pediatric organ transplant studies, evaluate their reliability and validity, examine factors and group differences related to anxiety, and identify promising scales for this population. Methods A systematic search was conducted using the terms “(Anxiety) AND (organ transplant) AND (child* OR youth OR pediatric* OR adolescen*).” Ten electronic databases were accessed. Results Eighteen anxiety scales from 30 articles were identified. Fourteen scales measured specific anxiety types. Most scales demonstrated good to excellent reliability and validity. Associations between anxiety and demographics, psychological well-being, factors related to illness and treatment were observed. Five types of anxiety-related differences among groups and 6 promising anxiety scales for the target population were identified. Discussion General and specialized anxiety scales were identified. Incomplete reporting of psychometric evidence restricted the quality assessment. Limitations include cultural and publication biases. Future research should focus on transplant-specific scales with psychometric validation across culturally diverse settings to ensure their quality and applicability. Conclusion This review identified well-validated scales, such as State-Trait Anxiety Inventory for Children and Generalized Anxiety Disorder-7, effective for quick screening. Specialized instruments were used for nuanced anxiety concepts such as needle-related anxiety, illness-specific anxiety, and anxiety during the transition to adult care, but further psychometric validation is needed.
