Outcome after renal transplantation.: Part II:: Quality of life and psychosocial adjustment

Knowledge of health-related quality of life (QOL) and psychosocial adjustment (PA) in children after renal transplantation (RTPL) is limited. QOL and PA were evaluated by standardized tests in patients after RTPL. Thirty- seven children of median age 14.5 years (range 6.5 +/- 17 years) were investigated a mean 4.5 years (range 0.5 +/- 12.8 years) after RTPL. Child- and parent- rated QOL was evaluated with the Child Quality of life Questionnaire of The Netherlands Organization for Applied Scientific Research Academical Medical Centre (TNO-AZL). PA was assessed by the Child Behaviour Checklist (CBCL) providing parental reports of a child's behaviour. In patients' self- ratings, the QOL dimension physical complaints (P < 0.0005) scored significantly better than that of healthy controls, whereas the dimension positive emotional functioning was impaired (P= 0.02). Parents rated motor functioning (P= 0.002), autonomy (P= 0.01), cognition (P= 0.04) and positive emotions (P < 0.0005) as significantly impaired. Parents also assessed PA significantly (P= 0.02) impaired with regard to internalizing behaviour. Dialysis duration, young age at RTPL, living- related donation, steroid treatment, adverse family relationships and maternal distress had a significantly negative impact on QOL and PA (P < 0.05). Patients rated QOL higher than did healthy controls. Parents evaluated their children's QOL and PA more pessimistically than did the patients themselves. Both illness-related variables and family environment played an important role.