Health-related quality of life and sleep among Chinese children after living donor liver transplantation

LDLT is a well-established treatment for most terminal liver diseases in children. Survival rates have improved, yet few studies have considered HRQoL or sleep problems in LDLT recipients. In this cross-sectional study, we enrolled 51 children who had undergone LDLT in Renji Hospital. PedsQL 4.0 Generic Core Scales, PedsQL 3.0 Transplant Module, and Pediatric Sleep Questionnaire were used to assess outcomes. Of all participants, 11.8% (6/51) reported low total HRQoL scores. Participants' scores on most HRQoL subscales were comparable to the scores of healthy children. However, compared with solid organ transplant recipients, LDLT recipients scored significantly lower in About My Medicines II (t=3.092, p=0.002) and Worry (t=2.760, p=0.006). Sleep problems (41.2%) were common among participants. Hierarchical regression analyses showed that SRBD accounted for significant variance in HRQoL on total generic HRQoL (R-2=0.446, p<0.001), psychosocial health (R-2=0.372, p=0.001), physical health (R-2=0.345, p=0.003), total transplant-specific HRQoL (R-2=0.514, p<0.001), About My Medicines I (R-2=0.365, p=0.013), My Transplant and Others (R-2=0.334, p=0.005), Pain and Hurt (R-2=0.544, p<0.001), Worry (R-2=0.401, p=0.001), Treatment Anxiety (R-2=0.526, p<0.001), How I Look (R-2=0.221, p=0.040), and Communication (R-2=0.343, p=0.012). In conclusion, sleep problems are non-negligible in children after LDLT and predicted significant variance on HRQoL.