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. 2024 Feb 19;109(3):240-246.
doi: 10.1136/archdischild-2023-326432.

Life outcomes after paediatric kidney transplantation: a qualitative, biographical study in long-term survivors

Valentin Ritschl  1   2 , Tanja Stamm  3   2 , Axana Selzer  4 , Anna Boesendorfer  5 , Fabian Eibensteiner  4 , Lukas Kaltenegger  4 , Erika Mosor  1   2 , Maisa Omara  1 , Natalie Vachuda  1   2 , Lisa Sperl  1   2 , Eva K Masel  6 , Christoph Aufricht  4 , Michael Boehm  4
Affiliations

Life outcomes after paediatric kidney transplantation: a qualitative, biographical study in long-term survivors

Valentin Ritschl et al. Arch Dis Child. .

Abstract

Objective: The objective of this study was to analyse the narrative life stories of children with end-stage kidney disease (ESKD) and their families to determine how health professionals can effectively support these children to achieve better life outcomes.

Design: Qualitative narrative biographic study.

Setting: We invited every long-term survivor of paediatric kidney transplants and their families at the Medical University of Vienna between 2008 and 2013 to participate in this study.

Participants: Nineteen patients (women: n=8, 42%) and 34 family members (women: n=22, 65%) were interviewed. The patients had a mean age of 7.6 (SD±5.6) years at the time of transplantation and 22.2 (SD±5.4) at the time of interview.

Main outcomes measures: A qualitative narrative biographical analysis was combined with computational structured topic models using the Latent Dirichlet Allocation.

Results: The overarching finding was the desire for normality in daily life in long-term survivors and their families but with different perceptions of what normality looks like and predominance of this aspect evolving. Different strategies were used by patients (focused on their advancement) and caregivers (normality for all family members). Siblings played a major role in supporting survivors' social inclusion.

Conclusions: The strong desire for normality confirms recent findings of the Standardised Outcomes in Nephrology Group initiative, which proposes survival and life participation as core outcomes in children with chronic kidney disease. Our study should be a starting point for an international effort to identify typologies and stratified interventions for children with ESKD and their families, particularly siblings.

Keywords: Child Development; Nephrology; Qualitative research.

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Conflict of interest statement

Competing interests: TS reports grants and personal fees from AbbVie, grants and personal fees from Roche and personal fees from Sanofi, Takeda and Novartis outside the submitted work. All other authors declare: No financial or non-financial benefits have been or will be received from any party related to the article's subject.

Figures

Figure 1
Figure 1
Course of end-stage kidney disease (ESKD) and kidney replacement therapy (KRT) of patients interviewed for this study. The graph shows the course of ESKD, including the time point of the interview. The time points of dialysis and kidney transplantations (KTX) are marked in the timeline. The duration between the different KRTs is shown with a line.
See this image and copyright information in PMC

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