Transplant Journal of Australasia

Aims Understand unique patient-reported outcomes and measurement in paediatric liver transplant (PLT) survivors and develop recommendations for integrating patient-reported outcome measures (PROMs) into routine clinical care for PLT recipients within an Australian PLT service.

Method A comprehensive literature review and semi-structured interviews with subject matter experts were undertaken to analyse and synthesise key issues related to implementation. 

Conclusion PLT survivors are at significant risk of diminished health outcomes and reduced quality of life across all domains. PROMs capture important outcomes in PLT survivors not appreciated by conventional assessments. Integrating PROMs into PLT care standardises assessment of unmet need amid the inability to predict individual outcomes. Targeting modifiable outcomes supports survivorship care to improve outcomes and support meaningful survival throughout childhood into adult life. Implementation of PROMs in PLT is complex. Development of consensus is needed among liver transplant experts in health outcomes to measure and in PROM tool selection. Strategic practice and culture change is needed. Implementation strategies and supporting change through co-design are recommended.

Living donors offer an alternative pathway to kidney transplantation for people living with kidney failure. Worldwide, a shortage of deceased donor organs and increasing incidence of kidney failure have led to lengthy transplant wait times. Improving rates of living donation may be one strategy to improve access to transplant. Written from the point of view of a transplant nurse, this article will explore what motivates people to donate, identify barriers to living donation and discuss how living donation rates vary globally. Having a thorough understanding of these factors is vital to ensure that efforts to increase living donor rates are conducted both ethically and safely.

The journey pre and post renal transplant is often challenging and unpredictable. Currently, there is a significant focus on medical management of the patient pre and post kidney transplantation. Interdisciplinary involvement, such as accredited exercise physiology (AEP), is an important avenue to explore and consider for improving and tailoring an individual’s well-being and health-related quality of life post solid organ transplant. The implementation and benefits of exercise physiology in the renal transplant setting will be highlighted via the case studies discussed in this paper.