Cross-Sectional Analysis of Health-Related Quality of Life in Pediatric Liver Transplant Recipients

Abstract

Objective To investigate the distribution of health related quality of life in pediatric liver transplant recipients compared to a normative population. Study design Cross-sectional, multi-center study conducted at select SPLIT centers. Patients between 2-18 years of age, surviving liver transplantation by at least 12 months were eligible. Parent/guardian fluency in English or Spanish was required. Children ≥ 8 years and parents of all children completed the age appropriate versions of the PedsQL™ 4.0. Scores were compared to a healthy children sample (n=3911) matched by age group, gender, race/ethnicity and to a sample of pediatric cancer patients receiving chemotherapy and/or radiation. Results Participants included 65% (873/1339) of eligible patients. Mean age was 8.17±4.43 years and 55% were female. The total and subscales scores of PedsQL™ 4.0 were lower than healthy children (p<0.001) with effect sizes for self-report ranging from −0.25 for Emotional Functioning to −0.68 for School Functioning. Patients and their parents reported better physical functioning than cancer patients, but similar social and school functioning. Correlations between parent and self-reports were in the moderate agreement range. Conclusion Pediatric liver transplant recipients and their parents report lower HRQOL than controls with some domains equal to children receiving cancer therapy.

The adolescent and liver transplantation

“…This was confirmed when a cross-sectional study on quality of life was conducted on a population of 2-18 year-olds that included liver transplant recipients, healthy children and paediatric patients with cancer receiving chemotherapy and/or radiation: the transplant patients reported better physical functioning than the patients with cancer, but similar social and academic functioning [75].…”

Pediatric Liver Transplantation

“…Growth and social and physical development is normal in the absence of liver diseases such as Alagille. Alonso et al on behalf of the (SPLIT group studied 873 children surviving at least 12 months, mean age of 8.17 ± 4.43 years (from 22 centers) [81]. Using a 23-item PedsQL 4.0 (Mapi Research Institute, Lyon, France) generic core scales, which encompasses physical, emotional, social, and school functioning, they demonstrated that these children had moderately diminished health-related quality of life (HRQOL) as compared with healthy peers.…”

Liver transplant and quality of life in the pediatric population

“…The effect size for self-reported measures ranged from À0.25 for Emotional Functioning to À0.68 for School Functioning [5]. Bucuvalas et al [6] found that HRQOL improved with increasing interval from transplant.…”