Can we identify “at‐risk” children and adolescents for poor transplant outcomes in the psychosocial evaluation before solid organ transplantation? The reliability and validity study of Pediatric Transplant Rating Instrument (P‐TRI) in Turkish pediatric renal transplant patients

Abstract

Background: This study aims to translate the Pediatric Transplant Rating Instrument (P-TRI) to conduct a validity and reliability study on Turkish children and define a cutoff value of this scale.Method: A total of 151 pediatric kidney transplant patients were included in the study.The files of the patients were reviewed by two clinicians, and the scale was filled for inter-rater reliability. One of the clinicians filled the scale again after one month for intra-rater reliability. Glomerular filtration rate (GFR) and creatinine values were used for predictive validity. A GFR below <60 ml/min/1.73 m 2 and creatinine up to 3.0 mg/ dl was defined as risk factors.Results: Correlation of P-TRI with GFR (r = .252, p = .003) and creatinine (r = −.249, p = .002) was performed, and the internal consistency of the scale items as measured by Cronbach's alpha coefficient was found to be 0.825. When the test was performed again, the intra-class correlation coefficient was found as .922 for intra-rater reliability and as .798 for inter-rater reliability. For both creatinine and GFR, the best cutoff point for the total score was found to be 66.5. Conclusions:Patients who received P-TRI above 66.5 could be at risk in the posttransplant period. Identification of these patients before transplantation and following these young people more closely will aid in the prevention of serious consequences.The reliability and validity scores are satisfactory for use in transplantation clinics for psychosocial evaluation and compliance in Turkish pediatric renal transplantation patients.

Evaluation of the implementation of a “Pediatric Feasibility Assessment for Transplantation” tool in children and adolescents at Red Cross War Memorial Children's Hospital, Cape Town, South Africa

“…38 In lower-income settings, however, translation of tools from well-resourced settings may be inappropriate given individual resource restrictions, therefore development or adaptation of local tools are required. 38 The reality of limited resources in LMIC makes the disparity in accessing KRT more pronounced. 9,10,39 In this context, the pFAT may be appropriate for implementation in other resourcelimited settings, however, this requires further research to determine.…”

“…19,22,23,37 In pediatric transplantation, selection tools for transplant eligibility are not widely available across the world, with the exception of the P-TRI, which was developed in the USA 18 and recently adapted in Turkey. 38 In lower-income settings, however, translation of tools from well-resourced settings may be inappropriate given individual resource restrictions, therefore development or adaptation of local tools are required. 38 The reality of limited resources in LMIC makes the disparity in accessing KRT more pronounced.…”

“…Globally, various selection tools have been developed for use in adults to improve prediction of posttransplant outcomes at different times, but these tools may not be applicable in the pediatric context 19,22,23,37 . In pediatric transplantation, selection tools for transplant eligibility are not widely available across the world, with the exception of the P‐TRI, which was developed in the USA 18 and recently adapted in Turkey 38 . In lower‐income settings, however, translation of tools from well‐resourced settings may be inappropriate given individual resource restrictions, therefore development or adaptation of local tools are required 38 .…”