Epidemiological and Psychosocial Outcomes of Liver Graft Recipients Transplanted During Childhood

BACKGROUND: While pediatric liver transplantation has markedly improved long-term survival, adult outcomes remain insufficiently explored beyond graft function, particularly regarding mental health and disease understanding-key dimensions of meaningful survival. To this aim, we evaluated psychosocial, behavioral, and lifestyle outcomes of adults who received a liver transplant during childhood, using validated tools. METHODS: Fifty adult patients transplanted before 18 years of age at Cliniques Universitaires Saint-Luc completed an anonymous online questionnaire including measures of anxiety (STAI-Trait), depression (BDI-SF), and alcohol use (AUDIT), as well as questions on lifestyle, treatment adherence, and disease knowledge. RESULTS: The results showed that clinically relevant anxiety and depressive symptoms were reported in 49% and 33% of respondents, respectively. Problematic alcohol use was found in 8% of participants, and 24% reported never receiving medical counseling about alcohol risks. Only 31% could correctly explain the pathophysiology of their liver disease, and 36% were unaware of its transmissible genetic nature. Despite these challenges, 76% were professionally or academically active. CONCLUSION: These findings highlight the persistence of high psychological distress and limited disease understanding into adulthood, supporting the integration of mental health screening and patient education into long-term post-transplant care.