Predictors of return to work after kidney transplantation: a 12-month cohort of the Japan Academic Consortium of Kidney Transplantation study

Abstract

ObjectivesTo investigate the cumulative return-to-work (RTW) rate and to identify predictors of employment after kidney transplantation (KT).DesignRetrospective, outpatient-based cohort study.SettingThis was a single-centre study of the largest Japanese kidney transplant centre.ParticipantsWe selected Japanese kidney transplant recipients aged 20–64 years who were employed in paid jobs at the time of transplantation and who visited an outpatient clinic from December 2017 to March 2018. From 797 patients, we evaluated 515 in this study.InterventionsWe interviewed patients at an outpatient clinic and investigated the timing and predictors of RTW using logistic regression models.Primary and secondary outcome measuresThe primary outcome was the cumulative RTW rate, and the secondary outcome was to investigate the predictors of RTW after KT.ResultsAmong the 515 included recipients, the cumulative overall partial/full RTW rates at 2, 4, 6 and 12 months were 22.3%, 59.0%, 77.1% and 85.0%, respectively. The median duration from transplantation to RTW was 4 months. Regarding partial/full RTW, according to the multivariable analysis including all variables, male sex was a greater predictor for RTW than female sex (OR 2.05, 95% CI 1.32 to 3.20), and a managerial position was a greater predictor than a non-managerial position (OR 2.23, 95% CI 1.42 to 3.52). Regarding full RTW, male sex (OR 1.95, 95% CI 1.25 to 3.06) and managerial position (OR 1.95, 95% CI 1.25 to 3.06) were also good predictors.ConclusionsThe cumulative RTW rate was 85.0% 1-year post-transplantation. Given that cumulative RTW rates varied by sex and position, transplant and occupational physicians should support kidney transplant recipients in the aspect of returning to work.Trial registration numberUMIN000033449

Employment of patients with kidney failure treated with dialysis or kidney transplantation—a systematic review and meta-analysis

“…Most of the studies (81%) were cross-sectional in design, analysing data at a specific point in time. The cross-sectional studies [ 3 , 12 – 14 , 17 – 19 , 21 , 22 , 24 – 39 , 41 – 49 , 51 , 54 , 55 , 57 , 59 , 61 – 64 , 66 – 69 ] were small to medium sized with a median of 139–233 participants for kidney transplant and dialysis patients, while the cohort studies [ 4 , 20 , 23 , 40 , 50 , 52 , 53 , 56 , 58 , 60 , 65 ] were mainly larger population studies (median of 2103 for dialysis patients and 1254 for kidney transplant patients). More than half of the studies were single-centre studies, and the studies were mainly from high-income countries.…”

“… 16-65 (46) 58.5 Post-transplant employed: 39% 3 Markell 1997 [ 49 ] U.S. cross sectional 58 with kidney transplant patients from one outpatient clinic 1994 58% 20-67 (43) 50 Post-transplant employed: 43% 6 Matas 1996 [ 50 ] U.S. Cohort 636 with functioning kidney transplant 1985-1993 83% > 18 (41) 62 Pre-transplant employed: Full-time 39%; part-time 5% Post-transplant employed: Full-time 32%; part-time 1% 5 Matas 2001 [551] U.S. Cross sectional 1278 with primary living donor kidney transplant 1990-98 n.a. (32) 62 Post-transplant employed: Full-time 41%; part-time 4% 5 Messias 2014 [ 52 ] Brazil Cohort 358 with primary kidney transplants 2005-9 61.7 17-72 (37-49) 67 Post-transplant employed: 26% 6 Miyake 2019 [ 53 ] Japan Cohort 515 from one outpatient clinic being in paid employment at the time of transplant 2017-18 98% 20-64 68 Post-transplant employed: Full-time 76%; part-time 9% 5 Monroe 2005 [ 54 ] U.S. Cross sectional 78 with kidney transplant; in working age; a stratified sample from one center during a 10 yr period n.a. 33% 23-62 (46.5) 52 Post-transplant employed 49% 4 Nour 2015 [ 55 ] Canada Cross sectional 60 with kidney transplant and functioning graft from one clinic …”

Employment Status and Associations with Workability, Quality of Life and Mental Health after Kidney Transplantation in Austria

“…Facilitation of RTW was amongst the main predictive factors for improved QoL in KTRs [17], along with the interrelated reduction in adverse KTx-associated health events. In light of this knowledge, the assessment of individual factors geared towards the facilitation of employment is important in KTRs [18,19].…”

Employment of Patients With Kidney Failure Treated With Dialysis or Kidney Transplantation - A Systematic Review and Meta-Analysis

“…Most of the studies (81%) were cross-sectional in design, analysing data at a speci c point in time. The cross-sectional studies [3, 12-14, 17-19, 21, 22, 24-39, 41-49, 51, 54, 55, 57, 59, 61-64, 66-69] were small to medium sized with a median of 139-233 participants for kidney transplant and dialysis patients, respectively, while the cohort studies [4,20,23,40,50,52,53,56,58,60,65] were mainly larger population studies (median 2,103 for dialysis patients and 1,254 for kidney transplant patients). More than half of the studies were single-center studies, and the studies were mainly from high income countries.…”