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Long-term quality of life after kidney transplantation in childhood
P Morel1, P S Almond, A J Matas
1Department of Surgery and Pediatrics, University of Minnesota Hospital and Clinic, Minneapolis 55455.
Insights
Pediatric kidney transplant recipients with over 10 years of graft function demonstrate excellent long-term quality of life and favorable socioprofessional outcomes, indicating successful integration into adult life.
Area of Science:
- Pediatric Nephrology
- Transplant Surgery
- Quality of Life Research
Background:
- Kidney transplantation is the primary treatment for pediatric end-stage renal disease.
- Long-term quality of life and socioprofessional outcomes in these patients remain underreported.
Purpose of the Study:
- To evaluate the long-term quality of life and socioprofessional achievements of children who received kidney transplants before age 18.
- To assess outcomes in patients with at least 10 years of sustained graft function.
Main Methods:
- A survey was administered to 57 pediatric kidney transplant recipients with a minimum of 10 years of graft function.
- Data collected included demographics, educational and employment status, marital and parental status, and health-related quality of life indicators.
Main Results:
- 91% rated their health as good to excellent, with 93% reporting no work absence due to health.
- 89% expressed general life satisfaction, and 95% reported minimal interference of health with family life.
- Most participants reported positive social interactions and satisfaction with work/school performance, though body image was a concern for 32%.
Conclusions:
- Pediatric kidney transplant recipients with long-term graft survival achieve a high quality of life.
- These individuals demonstrate favorable socioprofessional integration and overall well-being into adulthood.
Abstract:
Transplantation is the treatment of choice for children with end-stage renal disease. However, the long-term quality of life and socioprofessional outcome for those with successful transplants have not previously been reported. We studied these factors in patients transplanted when less than 18 years old who currently have greater than or equal to 10 years of graft function. A total of 57 questionnaires were sent out; 57 (100%) responded [24 female and 33 male patients; average (+/- SD) age at tx = 10 +/- 5 years (0.9-17.7); average f/u = 15.6 +/- 3 years (10-26); current age = 26 +/- 5 years (12-38); 26 had greater than 1 transplant]. Of the 57 respondents, 9 are less than 18 (all are in school); 48 are greater than or equal to 18 (7 in school, 37 employed, 4 unemployed); 12 are married, 1 engaged, and 2 divorced; and 9 have children. While in school, 43 (75%) had participated in sports, 37 (65%) in other extracurricular activities; 7 (12%) were A and 33 (58%) B students; 15 (26%) received awards or scholarships. For those working, the range of occupations is broad (average work week = 41 +/- 5 hr). Health-related absence from work has been nonexistent for 93%. Health is rated as good to excellent by 91% and fair by 9%. The future is regarded as hopeful or promising by 80%. Similarly, 89% are satisfied with life in general; 95% said health never or seldom interferes with family life; 95% feel health and drug side effects are of no or minor concern in sexual relationships. Only 3% feel health is a problem in maintaining a sexual relationship (41% are not sexually active). Only 4% stated that health often interferes with social life; 98% meet with friends on a regular basis; 76% are satisfied with personal relationships and 8% dissatisfied; 91% are satisfied with their ability to perform at work or school and 5% dissatisfied. Of note, 32% are dissatisfied with body appearance. Major concerns are short stature and brittle bones. Major suggestions include education/support groups to deal with teasing at school and peer problems. We conclude that transplanted children with long-term graft function have a favorable social and professional outcome. Overall, quality of life seems excellent.