Health-related quality of life in pediatric liver transplant recipients compared with other chronic disease groups

Abstract

This cross-sectional, multicenter cohort study compares the level of HRQOL of pediatric LT recipients to children with other chronic health conditions. LT sample included 873 children who survived at least 12 months following LT. Six chronic disease samples were compiled from numerous studies, including over 800 patients with JRA, type 1 diabetes, cancer in remission, cardiac disease, end-stage renal disease, and inflammatory bowel disease. Generic HRQOL was measured from both the parental and patient perspective using the PedsQL™ 4.0 Generic Core Scales. Pediatric LT patients reported better physical health than children with JRA. According to parents, pediatric LT recipients had better HRQOL than children on renal dialysis on all domains except school functioning. Across all domains but emotional functioning, pediatric LT recipients reported significantly lower HRQOL than children with type 1 diabetes. Overall, pediatric LT patients reported HRQOL comparable to that of children who had undergone renal transplantation and patients with cancer in remission. Pediatric LT patients manifested impaired HRQOL similar to that of children with chronic diseases and these data suggest that they face ongoing challenges that warrant monitoring and indicate a need for interventions to improve their HRQOL.

Figure 1

Figure 2. Parent Proxy-Reported PedsQL^™ Scores for Liver Transplant Sample and Chronic Disease Groups

Note: § p ≤ .05, ‡ p ≤ .01, * p ≤ .001; Significant differences indicate comparisons between the pediatric liver transplant sample and other pediatric chronic disease groups; Liver transplant n = 869, Juvenile rheumatoid arthritis n = 97, Type 1 diabetes n = 310, Cancer off-treatment n = 94, Cardiac n = 222, Renal transplant n = 45, Renal dialysis n = 50, Inflammatory bowel disease n = 70.