Paediatric Liver Transplantation
The Importance of the PeLTQL
Liver transplantation is life-saving treatment for children with biliary atresia, hepatoblastoma, metabolic disorders, acute liver failure and other types of liver disease. One-year and five-year patient survival rates are well over 90 per cent and 85 per cent respectively at experienced centers.
While it is difficult to objectively and completely measure well being, health related quality of life (HRQOL) comprises the health-related aspects of life that contribute to wellness and meaning of life. This includes one’s perception of well being, and one’s perceived ability to fulfill certain life roles. HRQOL is a multidimensional construct that incorporates various health and non-health related factors.
HRQOL measures are believed to allow patient reporting and provide a more comprehensive view of an individual's status, which is complementary to traditional ways (e.g, bloodwork, ultrasound) of monitoring how a liver transplant recipient is using(1). Although liver transplantation is a life-saving procedure, it is not curative. Recipients require immunosuppressive medications and ongoing medical monitoring with new reasons to be monitored by their health-care provider team. As most paediatric liver recipients now live longer and longer lives, it is imperative to move beyond standard biomedical outcomes and includes quality of life assessment in follow-up. Assessing HRQOL permits us to hear the voice and perspective of the patient and has been found to predict, often better than physiologic measures, future health status, mortality, and resource utilization (2).