Current Lifestyle of Young Adults After Liver Transplantation During Childhood

Abstract

The authors studied the psychosocial adjustment of pediatric liver transplant (LT) recipients reaching adulthood. The study comprised phone interviews of 116 volunteers aged 17-33 years. Results were compared to those for healthy peers and 65 patients who were eligible for inclusion but did not participate. Participants' median age at LT was 6 years and the median period since LT was 15 years. Of the 116 participants, 76% considered their quality of life as good or very good. Seventy-five patients (65%) were attending schools, 27 of whom were 2 years or more below the age-appropriate level. Of the remaining 41 patients, 26 had a job and 15 were unemployed. Poor compliance with medications was reported by 52 patients (45%). Alcohol consumption was lower than in the reference population (p < 0.001). Anxiety, loneliness and negative thoughts were expressed by 53, 84 and 47% of the participants, respectively. Thirteen patients (11%) were being cared for by psychologists or psychiatrists. The 65 nonparticipants had greater psychological problems than the participants, and a lower educational level. In conclusion, after LT in early life, most patients displayed psychological vulnerability during early adulthood. The educational level of patients was lower than that of theirs peers.

Immunosuppressants: whatʼs new?

“…transplant paediatricians. Also the increasing numbers of LTx recipients reaching adulthood raise the issues of nonadherence [6], late graft loss [7], sexual health [8], de-novo tumours [9], and quality of life [10].…”

“…Nonadherence was significantly associated with episodes of late acute rejection (P < 0.001), with re-LTx (P < 0.006) and with death secondary to chronic rejection (P < 0.05). In a recent, interview based study on 117 paediatric LTx recipients aged between 17 and 33 years [10] poor compliance with medications was reported by 52 patients (45%). These results put a burden on the paediatric LTx team to encourage earlier responsibility and greater independence in their patients.…”

The adolescent and liver transplantation

“…Anxiety, loneliness and negative thoughts were reported by 53%, 84%, and 47% of the young adults interviewed. Among them, 11% were in the care of psychologists or psychiatrists [73]. In early adulthood these patients appear to be very vulnerable and, here again, they represent a group that should be offered a tailored follow-up.…”

The management of childhood liver diseases in adulthood

“…-Risk taking behaviour. Young adults with chronic liver disease and those who have undergone liver transplantation are just as likely to exhibit similar risk taking behaviours as the general population [38]. Further information and education is therefore required regarding smoking, the use of illicit drugs and alcohol.…”