Impact of Pediatric Kidney Transplantation on Long-Term Professional and Social Outcomes

Background. Kidney transplantation in childhood and adolescence implies a set of challenges to long-term social and professional integration. The aim of this study was to characterize the academic activity and the professional situation of pediatric patients undergoing kidney transplantation. Methods. Through a questionnaire, we obtained information from all patients aged <18 years who underwent kidney transplantation between 1984 and 2009. Results. During this period, 104 kidney transplantations were performed in 96 patients whose mean age was 13.9 ± 2.8 years. As of March 2010, their mean age was 26.3 ± 5.6 years and 57.1% were male subjects. Eighty-one patients (87.1%) had functioning grafts with 12 (12.9%) undergoing dialysis. The distribution of academic qualifications was not substantially different from the Portuguese average: 1.1% were at the lowest level (vs 4.6%); 17.6%, middle lower level (vs 25.7%), 34.1%, middle level (vs 36.2%); 28.6%, middle higher level (vs 22.8%), and 18.7% had obtained a university degree (vs 10.7%). At the end of follow-up, 13 patients (14.3%) were students, 52 (58.2%) had paid employment, and 14 (15.4%) received a pension. The unemployment rate was 17.5% (vs 9.3% of the general Portuguese population). The proportion of unemployed and retired subjects was higher among patients who had lost their kidney graft (26.1% vs 7.5% and 34.8 vs 9.0%, respectively; P = .001). Twenty-nine patients (32.2%) had independent lodging, 21 (23.1%) were married, and 12 (13.2%) had children. Higher academic qualifications were associated with independent lodging (P = .001). Forty-three percent of patients had a mean height below the 5th percentile (―2 standard deviation). However, mean height did not correlate with academic qualifications, independent lodging, marital life, or procreation. Conclusion. This group of patients showed encouraging academic, professional and social results. Graft loss may influence employment status.