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Updated: Aug 21, 2026
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
The psychosocial correlates of transplant survival
Esther Serrano-Ikkos1, Bryan Lask
1Great Ormond Street Hospital, Heart-Lung Transplant Unit, London WC1N 3HJ, UK. Ikkose@gosh.nhs.uk
Insights
Psychosocial factors did not predict survival in children awaiting lung transplants. Severe disability predicted longer survival, while parental hostility predicted shorter survival post-transplant.
Area of Science:
- Pediatric Pulmonology
- Transplant Surgery
- Child Psychology
Background:
- Organ shortages lead to high mortality in pediatric lung transplant candidates.
- Psychosocial factors' impact on survival in pediatric cystic fibrosis (CF) lung transplant recipients remains unexamined.
Purpose of the Study:
- To compare pre-transplant factors between pediatric CF patients who survived and those who died awaiting lung transplantation.
- To investigate correlations between pre-transplant factors and post-transplant survival duration.
Main Methods:
- 81 children with CF and their parents completed standardized interviews and assessments before lung transplant listing.
- Evaluated child's disability, psychiatric status, self-esteem, and family functioning.
- Assessed parental psychiatric status and marital relationship quality.
Main Results:
- 20% of children and 60% of parents had psychiatric disorders; 33% of parents reported marital issues.
- Psychological measures did not differ between survivors and non-survivors awaiting transplant.
- Post-transplant, severe physical disability correlated with longer survival (P=0.01), and parental hostility with shorter survival (P=0.04).
Conclusions:
- No evidence suggests using adverse psychosocial factors as a contraindication for pediatric lung transplantation.
- Severe physical disability and parental relationship dynamics appear to influence post-transplant outcomes.
Background:
due to the shortage of organs, half of the patients on the waiting list for transplantations die. Clinicians have a duty to identify those patients whom might benefit most. The correlation between psychosocial factors and survival in children who have received lung transplantation for CF has not been investigated.
Aims:
to examine: (1) differences in physical, demographic and psychological factors between two groups of children with CF, those who did or did not survive the waiting period for transplantation. (2) Correlations between these factors pre-transplantation and length of survival post transplantation.
Methods:
81 children--mean age 11 years 6 months--and their parents underwent semi-structured standardised interviews and completed standardised instruments prior to being placed on the transplantation waiting list. The following domains were measured: child's disability, psychiatric status and self-esteem; quality of marital relationship and parental psychiatric status; and family attitudes and functioning.
Results:
20% of the children on the waiting list had a psychiatric disorder and 60% of the parents scored within the psychiatric disorder range. One third of the parents had marital difficulties, and 20% of the families showed chaotic functioning. Only half of the children survived to receive transplantation. Survivors and non-survivors were comparable with regard to all psychological measures. A follow up of the transplanted children, ranging from 3 to 156 months post-transplantation, produced a group of nine survivors and 30 non-survivors. Only two pre-transplant factors showed a significant association with length of survival after transplantation. Severe physical disability was associated with longer survival (P=0.01), and parental hostility to partner was associated with a shortened life span (P=0.04). No other factors were significantly associated with length of survival.
Conclusion:
there is no evidence to suggest that adverse psychosocial factors should be used as a contraindication to transplantation.
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