Hélène Mellerio1, Corinne Alberti, Marylène Labèguerie, Béatrice Andriss, Emilie Savoye, Mathilde Lassalle, Christian Jacquelinet, Chantal Loirat. 1. 1 Inserm, CIE 5, Paris, France. 2 Unité d'Epidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France. 3 Université Paris Diderot, Sorbonne Paris Cité, Paris, France. 4 Agence de la Biomédecine, Direction Médicale et Scientifique, Saint-Denis-La Plaine, France. 5 Service de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France. 6 Address correspondence to: Chantal Loirat, M.D., Pediatric Nephrology Department, Hôpital Robert Debré, 48 Boulevard Sérurier, 75019 Paris, France.
Abstract
BACKGROUND: Little is known about the socioprofessional situation of adult-aged kidney-transplanted children. This nationwide French cohort study documented the socioprofessional outcomes of adults who underwent kidney transplantation before age 16 years between 1985 and 2002. METHODS: Of 890 patients, 624 were eligible for a questionnaire and 374 completed it (response rate=60%; men=193 and women=181). The data were compared with the French general population using an indirect standardization matched for gender, age, and period. RESULTS: The median ages were 27.1 years at survey time and 12.3 years at first transplantation. Of the participants, 31.1% lived with a partner (vs. 52.2%; P<0.01) and 35.7% lived with their parents (vs. 21.0%; P<0.01). When standardized for parental educational level, fewer participants had a high-level degree (≥3-year university level) and fewer women had a baccalaureate degree. Professional occupations were similar to the French general population, but unemployment was higher (18.5% vs. 10.4%; P<0.01). Independent predictive factors for poor socioprofessional outcome were primary disease severity (onset in infancy or hereditary disease), the presence of comorbidities or sensorial disabilities, low educational level of the patient or his parents, female gender, and being on dialysis after graft failure. CONCLUSIONS: Transplanted children, particularly girls and patients with low parental educational levels, require optimized educational, psychologic, and social support to reach the educational level of their peers. This support should be maintained during adulthood to help them integrate into the working population and build a family.
BACKGROUND: Little is known about the socioprofessional situation of adult-aged kidney-transplanted children. This nationwide French cohort study documented the socioprofessional outcomes of adults who underwent kidney transplantation before age 16 years between 1985 and 2002. METHODS: Of 890 patients, 624 were eligible for a questionnaire and 374 completed it (response rate=60%; men=193 and women=181). The data were compared with the French general population using an indirect standardization matched for gender, age, and period. RESULTS: The median ages were 27.1 years at survey time and 12.3 years at first transplantation. Of the participants, 31.1% lived with a partner (vs. 52.2%; P<0.01) and 35.7% lived with their parents (vs. 21.0%; P<0.01). When standardized for parental educational level, fewer participants had a high-level degree (≥3-year university level) and fewer women had a baccalaureate degree. Professional occupations were similar to the French general population, but unemployment was higher (18.5% vs. 10.4%; P<0.01). Independent predictive factors for poor socioprofessional outcome were primary disease severity (onset in infancy or hereditary disease), the presence of comorbidities or sensorial disabilities, low educational level of the patient or his parents, female gender, and being on dialysis after graft failure. CONCLUSIONS: Transplanted children, particularly girls and patients with low parental educational levels, require optimized educational, psychologic, and social support to reach the educational level of their peers. This support should be maintained during adulthood to help them integrate into the working population and build a family.
Authors: Alexander James Hamilton; Fergus J Caskey; Anna Casula; Carol D Inward; Yoav Ben-Shlomo Journal: Clin J Am Soc Nephrol Date: 2018-10-16 Impact factor: 8.237
Authors: Phillippa K Bailey; Alexander J Hamilton; Rhian L Clissold; Carol D Inward; Fergus J Caskey; Yoav Ben-Shlomo; Amanda Owen-Smith Journal: BMJ Open Date: 2018-01-10 Impact factor: 2.692