Session Time: 2:15pm-3:45pm
Presentation Time: 3:15pm-3:27pm
Location: Room 115-C
ISW may limit medication-related comorbidities but intensive monitoring and unexpected rejection episodes may compromise HRQOL. We studied longitudinal HRQOL in pediatric LT recipients undergoing ISW in the iWITH (NCT101638559) trial.
METHODS: From 10/12 to 6/14, 88 subjects, mean age 10.4±3.4yrs (56% female; 58% biliary atresia; 35% living donor) initiated ISW. HRQOL was measured using parent proxy and self-reports of the PedsQL™4.0 Generic Core (GC) Scale, Multi-dimensional Fatigue (MF), and Transplant Modules (TM) at baseline (BL), 6 & 12 months after initiating ISW. Responses were analyzed using General Estimating Equations for trend over 12 months. Mean scores by rejection status at 12 months were compared by two-sided t-test with Bonferroni correction.
RESULTS: Response rate was 92%. Over 12 months, the Social Functioning subscale of the PedsQL™ 4.0 GC by parent-report and the Sleep/Rest Fatigue subscale of the PedsQL™ MF by self-report improved (both, p<0.03). Several parent-reported TM subscales showed improved trends, Total Score (p=0.05), Medication I (p=0.05), My Transplant &Others (p=0.003) and Treatment Anxiety (p=0.007). Parent and self-reported scores did not differ significantly by rejection status. Effect sizes (ES) were small for self-report data but moderate (≥0.50) or large (≥0.80) for parent-reported subscales with opposing trends from BL by rejection status
CONCLUSIONS: In this preliminary report, pediatric LT recipients undergoing ISW had modest longitudinal improvements in HRQOL over the first year. Trends in parent-reported scores suggest that rejection negatively impacts HRQOL. The durability of these outcomes requires extended follow-up.
To cite this abstract in AMA style:Mohammad S, Sundaram S, Venkat V, Martinez M, Lopez J, Magee J, Alonso E, Feng S. Changes in Health Related Quality of Life (HRQOL) in Pediatric Liver Transplant (LT) Recipients During Protocolized Immunosuppression Withdrawal (ISW): The iWITH Trial [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/changes-in-health-related-quality-of-life-hrqol-in-pediatric-liver-transplant-lt-recipients-during-protocolized-immunosuppression-withdrawal-isw-the-iwith-trial/. Accessed December 5, 2020.
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