The Journal of Pediatrics
Volume 155, Issue 4 , Pages 542-549.e5, October 2009

Adolescent Experiences Following Organ Transplantation: A Systematic Review of Qualitative Studies

  • Allison Tong, PhD

      Affiliations

    • Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia
    • School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
    • Corresponding Author InformationReprint requests: Allison Tong, The Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia.
  • ,
  • Rachael Morton, MScMed (Clin Epidemiol)

      Affiliations

    • School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
  • ,
  • Kirsten Howard, PhD

      Affiliations

    • School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
  • ,
  • Jonathan C. Craig, PhD

      Affiliations

    • Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia
    • School of Public Health, University of Sydney, Sydney, NSW 2006, Australia

Received 9 December 2008; received in revised form 2 March 2009; accepted 3 April 2009. published online 25 June 2009.

Objective

To describe the experiences of adolescents who underwent organ transplantation.

Study design

We conducted a systematic review of qualitative studies that explored the experiences of adolescents who underwent organ transplantation. We searched 5 electronic databases (to week 3 of July 2008) and reference lists of relevant articles.

Results

Eighteen articles reporting the experiences of 313 adolescent organ transplant recipients were included. Five major themes were identified: (1) redefining identity (seeking normality, anxiety and disappointment, adopting a positive attitude, desiring independence); (2) family functioning (parental overprotection, sibling support); (3) social adjustment (support networks, peer rejection, maintaining schoolwork, participation in physical activities); (4) managing medical demands (assuming responsibility, dependence on caregivers, disruption to lifestyle, vigilant adherence, pain and discomfort); and (5) attitude toward the donor (obligation of gratitude, strengthened relationship, concerns about risks to donor).

Conclusions

Although transplantation offers adolescents a better chance of survival and increased freedom and energy, it poses many challenges. A multifaceted response is needed to equip adolescent transplant recipients with skills and capacities to help them achieve a sense of normality, cope with fear of death and organ rejection, gain acceptance among their peers, build confidence in learning, and resolve relationship tensions with the living donor.

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 Supported by in part by a postdoctoral research fellowship funded under the National Health and Medical Research Council Capacity Building Grant in Population Health (ID 457281, to A.T.). The authors declare no conflicts of interest.

PII: S0022-3476(09)00362-X

doi:10.1016/j.jpeds.2009.04.009

The Journal of Pediatrics
Volume 155, Issue 4 , Pages 542-549.e5, October 2009