*Purpose: Psychosocial assessment prior to liver transplantation is essential to ensure that caregivers and pediatric patients are adequately prepared for this complex process. There are several standardized pre-transplant psychosocial assessment tools in the adult literature. However, no such tool exists for pediatric liver transplant. In our study, we aim to develop a patient-centered, standardized questionnaire for the pre-transplant evaluation of pediatric liver transplant patients.

*Methods: In the first phase of our study, we recruited parents and adolescent patients who have undergone liver transplantation at Texas Children’s Hospital to participate in separate focus groups. Each focus group was led by trained graduate students, took approximately 1 hour, and was digitally recorded and transcribed. The purpose of these focus groups was to give patients and their parents the opportunity to discuss and highlight their experiences with the transplantation process, with an emphasis on perceived challenges during the process.

*Results: The majority (67%) of families interviewed strongly agree that they experienced stress during the transplant process (Figure 1). Family support mitigated this stress for many, as well as being adequately educated about the process. A third (33%) of families had difficulty attending appointments post-operatively (Figure 2). Most had private insurance, but some families report alternate methods of payment (Figure 3).

*Conclusions: The focus groups show that there are many psychosocial challenges our patients face, most notably with transportation and separation of family units with out-of-state patients and with large and frequently changing medical teams among all patients. Patients transplanted during the COVID-19 pandemic noted difficulty with hospital restrictions during long stays. The qualitative data gathered in this phase of the study will be applied with data from the adult literature in order to develop specific items for our pre-transplant psychosocial assessment tool. Future studies will focus on validation of our tool in a larger cohort of pediatric liver transplant patients.

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