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Tissue Engineering of the Intestine in a Murine Model
Published on: December 1, 2012
Pediatric health-related quality of life after intestinal transplantation
K D Ngo1, D G Farmer, S V McDiarmid
1Department of Pediatrics and Surgery, University of California, Los Angeles, Los Angeles, CA 90095-1752, USA. kngo@llu.edu
Insights
Health-related quality of life (HRQOL) is lower in pediatric intestinal transplant (ITx) recipients compared to healthy children. Both patient and parent reports indicated significant differences in physical health, social functioning, and school performance.
Area of Science:
- Pediatric Gastroenterology
- Transplant Surgery
- Health Outcomes Research
Background:
- Improving outcomes for pediatric intestinal transplant (ITx) necessitates a focus on health-related quality of life (HRQOL).
- Limited data exists on the HRQOL of pediatric ITx survivors.
- Assessing HRQOL is crucial for comprehensive post-transplant care.
Purpose of the Study:
- To evaluate the feasibility of measuring HRQOL in pediatric ITx recipients.
- To quantify HRQOL using validated instruments.
- To compare HRQOL in ITx recipients with healthy normal (NL) children.
Main Methods:
- Utilized the Child Health Questionnaire (CHQ) and Pediatric Quality of Life (PedsQL 4.0) instruments.
- Administered surveys to pediatric ITx patients and their parents during outpatient visits.
- Enrolled all 24 eligible patients (median age 6.0 yr; median 2.8 yr post-transplant).
Main Results:
- Parental reports showed significantly lower HRQOL in physical health and social functioning compared to healthy norms.
- Patient reports using PedsQL 4.0 indicated lower school functioning and psychosocial health.
- No significant difference in HRQOL was found using the CHQ instrument for patient reports.
Conclusions:
- Pediatric ITx recipients report significantly lower HRQOL across multiple domains compared to healthy children.
- Parental perception of HRQOL is notably diminished post-intestinal transplant.
- Validated instruments like PedsQL 4.0 are sensitive to HRQOL deficits in this population.
Abstract:
As outcomes after ITx improve, greater emphasis is needed on HRQOL. The primary aims of this study were to (i) assess the feasibility of measuring HRQOL in pediatric ITx recipients, (ii) measure HRQOL using validated instruments, and (iii) compare HRQOL in ITx recipients to healthy normal (NL) children. The CHQ and Pediatric Quality of Life (PedsQL4.0) instruments were administered to both patients and parents at outpatient visits. All 24 eligible patients were enrolled. The median age at study enrollment was 6.0 yr (range: 2-18 yr), and the median time from transplant to study enrollment was 2.8 yr (range: 0.5-11.8 yr). The majority of subjects were male (58%), Latino (58%), and liver-inclusive (92%) recipients. For CHQ and PedsQL4.0, parental responses were significantly lower in multiple categories including physical health and social functioning compared to healthy norms. Patient responses were not different from NL using CHQ but using PedsQL4.0 were significantly lower in the school functioning subcategory and psychosocial health summary score. HRQOL as reported by children and families after ITx is significantly lower in multiple categories compared to NL.
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Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include: