Psychosocial outcome and resilience after paediatric liver transplantation in young adults.


Journal

Clinics and research in hepatology and gastroenterology
ISSN: 2210-741X
Titre abrégé: Clin Res Hepatol Gastroenterol
Pays: France
ID NLM: 101553659

Informations de publication

Date de publication:
04 2019
Historique:
received: 05 03 2018
revised: 15 08 2018
accepted: 27 08 2018
pubmed: 10 2 2019
medline: 31 3 2020
entrez: 10 2 2019
Statut: ppublish

Résumé

The long-term psychosocial outcome of young adults after paediatric liver transplantation (LT) was investigated with the focus on day-to-day living. We aimed to capture patients' subjective perceptions of well-being and autonomy based on key physical outcome parameters. All patients following paediatric LT at Hannover Medical School born before 2002 with a post-transplant follow-up of at least four years were included in this study. This retrospective observational study compared psychosocial parameters obtained from a self-designed 77-item questionnaire with standard clinical outcome variables. Eighty-two patients (male: 57%) aged 13-41 years were included in the survey within a three-month period (response rate: 41%). With an adherence rate of 33%, all but two patients were immunosuppressed. In total, 53 patients had transitioned to adult care largely without problems. Eighty-three percent (n = 68) evaluated their current health status as "(very) good". Sixty-seven patients (82%) did not experience health-related anxiety in daily life. Our results demonstrate psychological stability and high self-esteem of young patients, as well as good integration into society and a high degree of normality during daily life after LT. Adherence rates are lower than anticipated and do not correlate with patients' understanding of their medical condition.

Sections du résumé

BACKGROUND AND OBJECTIVE
The long-term psychosocial outcome of young adults after paediatric liver transplantation (LT) was investigated with the focus on day-to-day living. We aimed to capture patients' subjective perceptions of well-being and autonomy based on key physical outcome parameters.
METHODS
All patients following paediatric LT at Hannover Medical School born before 2002 with a post-transplant follow-up of at least four years were included in this study. This retrospective observational study compared psychosocial parameters obtained from a self-designed 77-item questionnaire with standard clinical outcome variables.
RESULTS
Eighty-two patients (male: 57%) aged 13-41 years were included in the survey within a three-month period (response rate: 41%). With an adherence rate of 33%, all but two patients were immunosuppressed. In total, 53 patients had transitioned to adult care largely without problems. Eighty-three percent (n = 68) evaluated their current health status as "(very) good". Sixty-seven patients (82%) did not experience health-related anxiety in daily life.
CONCLUSIONS
Our results demonstrate psychological stability and high self-esteem of young patients, as well as good integration into society and a high degree of normality during daily life after LT. Adherence rates are lower than anticipated and do not correlate with patients' understanding of their medical condition.

Identifiants

pubmed: 30737022
pii: S2210-7401(18)30181-5
doi: 10.1016/j.clinre.2018.08.017
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

155-160

Informations de copyright

Copyright © 2018. Published by Elsevier Masson SAS.

Auteurs

Katrin Mayer (K)

Division for Paediatric Gastroenterology and Hepatology, Centre for Paediatric and Adolescent Medicine, Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.

Norman Junge (N)

Division for Paediatric Gastroenterology and Hepatology, Centre for Paediatric and Adolescent Medicine, Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.

Imke Goldschmidt (I)

Division for Paediatric Gastroenterology and Hepatology, Centre for Paediatric and Adolescent Medicine, Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.

Christoph Leiskau (C)

Division for Paediatric Gastroenterology and Hepatology, Centre for Paediatric and Adolescent Medicine, Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.

Thomas Becker (T)

Clinic for General, Visceral, and Transplant Surgery, Hannover Medical School, Hannover, Germany; Clinic for General, Visceral, and Transplant Surgery, UKSH, Kiel, Germany.

Frank Lehner (F)

Clinic for General, Visceral, and Transplant Surgery, Hannover Medical School, Hannover, Germany.

Nicolas Richter (N)

Clinic for General, Visceral, and Transplant Surgery, Hannover Medical School, Hannover, Germany.

Rolf van Dick (R)

Psychology, Goethe University, Frankfurt, Germany; Work Research Institute (AFI), Oslo, Norway.

Ulrich Baumann (U)

Division for Paediatric Gastroenterology and Hepatology, Centre for Paediatric and Adolescent Medicine, Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany; University of Birmingham, Medical School, Institute for Immunology and Immunotherapy, Birmingham, UK.

Eva-Doreen Pfister (ED)

Division for Paediatric Gastroenterology and Hepatology, Centre for Paediatric and Adolescent Medicine, Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany. Electronic address: doreen@mh-hannover.de.

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