The relationship between symptom clusters and quality of life in pediatric liver transplant recipients

To examine the associations between symptom clusters and quality of life (QoL) in pediatric liver transplant recipients.

From June 2022 to June 2023, a cross-sectional study was conducted with 129 pediatric liver transplant recipients (mean age: 4.1 years old) at 3 tertiary hospitals in Guizhou Province, China. QoL and symptom clusters were measured using the validated Chinese version of Pediatric Quality of Life Inventory Measurement Models and the Modified Transplant Symptom Occurrence and Symptom Distress Scale, respectively. The data were analyzed using the Pearson correlation and linear regression.

The mean QoL score was 70.05 ± 19.37. Pearson correlation revealed that neurological system-related (r = -0.560 to -0.282, p < 0.05), digestive system-related (r = -0.522 to -0.160, p < 0.05), and medication-related (r = -0.648 to -0.344, p < 0.05) symptom clusters were negatively correlated with the overall QoL scores and all dimensions. Linear regression showed that the child's primary disease diagnosis (β = -0.157, p = 0.038) and neurological- (β = -0.436, p < 0.001), digestive- (β = -0.326, p < 0.001), and medication-related symptom clusters (β = -0.161, p = 0.025) were significant predictors of QoL (adjusted R² = 0.385, p < 0.001).

The QoL of pediatric liver transplant recipients was sub-optimal and warranted clinical attention. The neurological-, digestive-, and medication-related symptom clusters are significant predictors of QoL. Nursing care including assessment and management of these key symptom clusters may be considered to improve the well-being of children after liver transplantation.

These findings highlight the need for routine screening of symptom clusters in pediatric liver transplant recipients and for developing targeted nursing interventions to manage co-occurring symptoms, thereby improving health-related quality of life in this population.