Immunosuppression after pediatric liver transplant: The parents' perspective

Area of Science:

• Pediatric Gastroenterology and Hepatology
• Transplant Immunology
• Patient-Reported Outcomes

Background:

• Achieving optimal outcomes after pediatric liver transplantation (LT) involves balancing immunosuppression to prevent graft injury while minimizing systemic complications.
• Understanding the parental perspective on this delicate balance is crucial for comprehensive care.

Purpose of the Study:

• To explore parental concerns and perspectives regarding immunosuppression management in children following liver transplantation.
• To identify key areas of uncertainty and concern for caregivers to improve patient care strategies.

Main Methods:

• An internet-based survey was administered to parents of children who had undergone liver transplantation.
• Data collected included demographics, time since transplant, and parental concerns regarding immunosuppression, rejection, and complications.

Main Results:

• Parents expressed greater concern about immunosuppression complications than transplant rejection, even among those on monotherapy.
• Caregivers reported higher certainty in their child's immunosuppression regimen preventing rejection compared to mitigating complications.
• Time since LT did not significantly correlate with the level of concern for rejection or complications.

Conclusions:

• Caregivers of pediatric liver transplant recipients exhibit heightened concern and uncertainty regarding immunosuppression complications versus rejection risk.
• Incorporating parental and patient perspectives into immunosuppression counseling is vital for achieving ideal long-term outcomes in pediatric liver transplantation.