Differences in parents of pediatric liver transplantation and chronic liver disease patients

Evaluation of Quality of Life and Psychosocial Status in Children with Inflammatory Bowel Disease

Objectives

Inflammatory bowel disease (IBD) in children is a chronic condition that affects the psychosocial status and physical activities of children and their parents. This study aimed to investigate the impact of IBD on the quality of life of adolescents and their families and the variability of behavioral and emotional adjustment issues compared to a healthy control group.

Methods

This study was designed as a prospective controlled study. A total of 159 cases were included, consisting of 84 IBD patients aged between 8-17 years and 75 healthy control subjects. All children and their parents included in the study were administered the Pediatric Quality of Life Inventory (PedsQL) and the Strengths and Difficulties Questionnaire (SDQ) for adolescents and parents.

Results

The median ages of the IBD children and the control group were 13.5 and 13, respectively. Of all 154 cases, 87 were female and 72 were male. Among the patients diagnosed with IBD, 39 had Crohn's disease, 37 had ulcerative colitis, and 8 had indeterminate colitis. It was observed that both the PedsQL and SDQ scores of children and parents with IBD were statistically significantly lower in both physical and psychosocial scoring (p=0.01 and p<0.001, respectively). A weak but statistically significant correlation was observed between the PedsQL and SDQ results applied to parents (rho=-0.214, p=0.007) and children (rho=-0.208, p=0.008).

Conclusion

The lower PedsQL and SDQ scores in children with IBD and their parents suggest that IBD negatively affects psychosocial, physical, and behavioral adaptations in children.

Effect of Hemodynamic Monitoring Systems on Short-Term Outcomes after Living Donor Liver Transplantation

Background and Objectives: To evaluate the effects of the pulse index continuous cardiac output and MostCare Pressure Recording Analytical Method hemodynamic monitoring systems on short-term graft and patient outcomes during living donor liver transplantation in adult patients. Materials and Methods: Overall, 163 adult patients who underwent living donor liver transplantation between January 2018 and March 2022 and met the study inclusion criteria were divided into two groups based on the hemodynamic monitoring systems used during surgery: the MostCare Pressure Recording Analytical Method group (n = 73) and the pulse index continuous cardiac output group (n = 90). The groups were compared with respect to preoperative clinicodemographic features (age, sex, body mass index, graft-to-recipient weight ratio, and Model for End-stage Liver Disease score), intraoperative clinical characteristics, and postoperative biochemical parameters (aspartate aminotransferase, alanine aminotransferase, total bilirubin, direct bilirubin, prothrombin time, international normalized ratio, and platelet count). Results: There were no significant between-group differences with respect to recipient age, sex, body mass index, graft-to-recipient weight ratio, Child, Model for End-stage Liver Disease score, ejection fraction, systolic pulmonary artery pressure, surgery time, anhepatic phase, cold ischemia time, warm ischemia time, erythrocyte suspension use, human albumin use, crystalloid use, urine output, hospital stay, and intensive care unit stay. However, there was a significant difference in fresh frozen plasma use (p < 0.001) and platelet use (p = 0.037). Conclusions: The clinical and biochemical outcomes are not significantly different between pulse index continuous cardiac output and MostCare Pressure Recording Analytical Method as hemodynamic monitoring systems in living donor liver transplantation. However, the MostCare Pressure Recording Analytical Method is more economical and minimally invasive.

The mediating effect of sense of coherence on the caregiver ability-caregiver burden relationship for caregivers of children with liver transplantation in China

BACKGROUND

Caregivers of children who have had liver transplantation often experience chronic care stress. Previous studies have focused on caregivers' negative feelings (e.g., caregiver burden), but few studies have focused on caregivers' positive feelings (e.g., sense of coherence) and caregiver ability.

OBJECTIVES

The study purpose was to investigate the status of the burden of caregivers of children with liver transplantation, and to explore the mediating role of sense of coherence between caregiver ability and caregiver burden.

METHODS

There were 461 questionnaires collected from a tertiary-level hospital from caregivers of children who had liver transplantation from April to June 2022. Demographic data, Family Caregiver Task Inventory, Sense of Coherence Scale-13, and Zarit Burden Interview were used. The STROBE checklist was monitored.

RESULTS

The average caregiver burden score was 32.19 ± 16.71. The distribution of caregiver burden levels was mild (42.52%), none (26.25%), moderate (24.95%), and severe (6.29%). Caregiver ability score was negatively correlated with caregiver burden score; however, sense of coherence score was negatively correlated with caregiver burden score. Caregiver ability partially mediated caregiver burden through sense of coherence (38.51%).

CONCLUSION

The caregiver burden level was not heavy in general. Both positive and negative feelings were present in caregivers. Caregiver ability also reduced the caregiver burden through sense of coherence.

Factors affecting anxiety, depression, and self-care ability in patients who have undergone liver transplantation

BACKGROUND

Depression, anxiety, and altered self-care ability are among the most important factors affecting the quality of life of liver transplant recipients. Depending on the severity of the underlying liver disease, signs and symptoms of anxiety and depression may become more pronounced.

AIM

To evaluate the factors affecting depression, anxiety and self-care abilities of liver transplant recipients.

METHODS

Recipients who are ≥ 18 years and who underwent liver transplantation at Inonu University Liver Transplantation Institute were included in this descriptive and cross-sectional study. Sample size analysis showed that the minimum number of recipients should be 301 (confidence level = 95%, confidence interval = 2.5, population = 1382). Three hundred and twenty recipients were interviewed and 316 recipients that have answered the questionnaires accurately were analyzed. The dependent variables were the Beck Depression Scale, State-Trait Anxiety Scale (Form I and II), and Self-Care Agency Scale. The independent variables of the study were sociodemographic characteristics, biliary complications, hepatocellular carcinoma, recommending liver transplantation to other patients, and the interval of out-patient clinic visits.

RESULTS

Self-care ability scores were lower (P = 0.002) and anxiety scores were higher (P = 0.004) in recipients with biliary complications. On the other hand, in recipients with hepatocellular carcinoma, self-care scores were lower (P = 0.006) while depression (P = 0.003) and anxiety scores (P = 0.009) were higher. Liver transplantation recipients with a monthly income < 3000 Turkish liras had higher depression (P < 0.001) and anxiety (P = 0.003) scores. The recipients who stated that they would not recommend liver transplantation to others had lower self-care scores (P = 0.002), higher depression (P < 0.001), higher state anxiety (P = 0.02), and trait anxiety (P < 0.001) scores.

CONCLUSION

Presence of biliary complications and hepatocellular carcinoma, low income level, and an obligation for monthly visits to the outpatient clinic are factors that are found to affect self-care capability, depression, and anxiety.