Predictors of Return to Work 12 Months After Solid Organ Transplantation: Results from the Swiss Transplant Cohort Study

Abstract

Background Return to work with or after a chronic disease is not a very well understood process, influenced by a variety of personal, professional, societal and medical factors. The aim of this study is to identify predictors for return to work 12 months after a solid organ transplant applying a bio-psycho-social model. Methods This study is based on patients included in the Swiss Transplant Cohort Study, a national prospective multicentre cohort, who underwent a first solid organ transplant (kidney, liver, heart, lung). Bio-psycho-social factors were tested and predictors of return to work identified using logistic regression models. Results Among the 636 patients included in the study, 49.8% (317) were employed 12 months post-transplant. The major predictor for returning to work 12 months posttransplant was pre-transplant employment status (OR 10.8). Accordingly, the population was stratified in employed and not employed pre-transplant groups. Age, self-perceived health (6 months post-transplant) and the transplanted organ were significantly associated with post-transplant employment status in both groups. Return to work was influenced by education, depression (6 month post-transplant) and waiting time in the employed pre-transplant group and by invalidity pension in the not employed pre-transplant group. Conclusion Employment status pre-transplant being highly associated with employment status post-transplant, the process promoting return to work should be started well before surgery. Biomedical, psychological and social factors must be taken into account to promote return to work in transplanted patients.

Employment after lung transplantation in Poland – a single center study

“…The authors consider this result to be comparable with other countries, as Krivchenia et al estimated that 5-year salaried work was possible for 48% of the CF patients undergoing transplantation [12]. Pre-transplant employment seems to be one of the most important factors when it comes to returning to work after lung transplantation [5,7]. What is more, it is also an important factor of rejoining the workforce after liver transplantation [13].…”

“…Resuming or finding employment after becoming a graft recipient is just another measure of successful treatment. A Swiss transplant cohort study presented by Vieux et al [7] assessed the prospects of employment after the first solid organ transplantation (kidney, liver, heart or lung). The authors estimated that 49.8% of the studied recipients were employed 12 months after receiving the graft [7].…”

“…A Swiss transplant cohort study presented by Vieux et al [7] assessed the prospects of employment after the first solid organ transplantation (kidney, liver, heart or lung). The authors estimated that 49.8% of the studied recipients were employed 12 months after receiving the graft [7]. The highest employment rates after solid organ transplantation could be observed after kidney transplantation (58.6%) [1].…”

Multivariate analysis of biopsychosocial determinants of professional activity among patients after kidney or liver transplantation in Poland

“…In the group of men, the important factor determining employment after transplantation was the transplanted organ. Kidney patients being more likely to be employed after transplantation than non-kidney patients was also observed in other studies 10 11. Some authors indicated that the possible cause of this is longer experience with kidney transplantation compared with liver, heart or lung transplantation, or more complications observed in non-kidney recipients after surgery, hindering them from work 10 15 20…”

Pre‐transplant Social Adaptability Index and clinical outcomes in renal transplantation: The Swiss Transplant Cohort study

“…For instance, educational level and household income have been studied as risk factors for, respectively, sleep quality 34 and new-onset obesity. 35 Other studies have named pre-transplant employment status as a predictor of better post-transplant health (with health levels assumed based on post-transplant employment status) [36][37][38] ; however, prospective, reliably measured indicators of care deprivation-essential tools to identify the full impact of socioeconomic status on general and transplant-specific long-term health outcomes-are lacking. 33 The measurements of the Swiss Transplant Cohort Study (STCS), 39,40 a nationwide open cohort study, cover the SAI's variables, along with subsequently assessed outcomes.…”