Clinical family pre-transplant interviews: an efficient way to predict psychosocial difficulties after paediatric liver transplantation with a living donor

Rougier,Laure;Aujoulat, Isabelle;De Magnée, Catherine;de meester, Vanessa;Reding, Raymond;et.al.
(2019) 26th Annual Meeting of the Belgian Transplantation Society — Location: Anvers, Belgique (14.March.2019)

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From 1984 to 2018, 1120 paediatric liver transplantations (PLTs) have been performed, of which 438 with living donor (LD). We systematically conduct pre-transplant psychological assessments,which consist at least in a clinical family interview. We hypothesize that such approach may predict psychosocial difficulties for families in the course of the transplant. Methods: Content analysis of 130 pre-transplant reports written between 1/07/2014 and 31/10/2018, personal prospective notes by the psychologist and interviews of other members of the team. The results are based on the systematic analysis of the first 54 situations of living donor PLTs. After transplantation, 39/54 (72%) families did not experience particular psychosocial difficulties whereas 15 (28%) needed psychosocial support. Only 9 of these 15 situations had been identified as being at risk, through our clinical interview before trans-plantation. The red flags identified by the psychologist in relation to these families were in ade-quacy with the type of difficulties experienced after transplantation. Looking at the remaining 6 (11%) whose psychosocial risk had not been identified, we analysed whether it would have been possible to predict post-operative psychosocial adjustments. In 3 situations, medical complications were the main determinant of the non-predictable psychosocial difficulties. In 3 situations however, the risk might have been predicted if we had investigated morein-depth the larger environment of the family. Our results suggest that a systemic approach with at least a clinical family interview predicts in 89% psychosocial risks and points of attention for living donor candidates and their family before PLT.
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Rougier, L., Aujoulat, I., De Magnée, C., de meester, V., Janssen, M., Pire, A., Scheers, I., Smets, F., Sokal, E., Stephenne, X., Tambucci, R., Wintgens, A., & Reding, R. (2019). Clinical family pre-transplant interviews: an efficient way to predict psychosocial difficulties after paediatric liver transplantation with a living donor. 26th Annual Meeting of the Belgian Transplantation Society, Anvers, Belgique.