Employment 12 months after kidney transplantation: an in-depth bio-psycho-social analysis of the Swiss Transplant Cohort

Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model. All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation. Of the 689 included patients, 56.2% worked 12 months post- transplantation compared to 58.9% pre-transplantation. Age, education, self-perceived health (6 months post- transplantation), pre- transplantation employment and receiving an organ from a living donor are significant predictors of employment post- transplantation. Moreover, while self-perceived health increased post- transplantation, depression score decreased only among those employed 12 months post- transplantation. Pre- transplantation employment status was the main predictor for post- transplantation employment (OR = 18.6) and was associated with sex, age, education, depression and duration of dialysis. An organ from a living donor (42.1%) was more frequent in younger patients, with higher education, no diabetes and shorter waiting time to surgery. Transplantation did not increase employment in end-stage kidney disease patients but helped maintaining employment. Pre-transplantation employment has been confirmed to be the most important predictor of post-transplantation employment. Furthermore, socio-demographic and individual factors predicted directly and indirectly the post-transplantation employment status. With living donor, an additional predictor linked to social factors and the medical procedure has been identified

Facteurs influençant le retour au travail après transplantation chez 61 patients rénaux ou hépatiques

Le taux de retour au travail après greffe est généralement bas. Or, on sait que le retour au travail après greffe améliore la qualité de vie des transplantés. Le but de notre étude était donc de comprendre les raisons possibles à ce faible taux en montrant les facteurs professionnels, individuels ou médicaux pouvant l'influencer. Parmi les 61 greffés rénaux ou hépatiques suivis au centre de transplantation d'organe (CTO) du CHUV, 39% ont repris le travail après greffe. Trois facteurs étaient significatifs de retour au travail après greffe, à savoir «travail avant greffe», «diplôme» et «âge < 45 ans». Ainsi, il est utile pour la pratique médicale de connaître les facteurs potentiels influençant le retour au travail car cela permet d'évaluer, au stade prégreffe, les chances de retour au travail et si besoin de proposer des mesures spécifiques le favorisant

Predictors of receiving a kidney donation from a living vs. a non-living donor.

<p>Predictors of receiving a kidney donation from a living vs. a non-living donor.</p

Predictors of pre-Tx employment status in kidney patients.

<p>Predictors of pre-Tx employment status in kidney patients.</p

Evolution of self-perceived health (visual analogue scale) pre-Tx (0), 6 and 12 months post-Tx, by employment status 12 months post-Tx.

<p>Evolution of self-perceived health (visual analogue scale) pre-Tx (0), 6 and 12 months post-Tx, by employment status 12 months post-Tx.</p

Employment_postTx.xls

The database contains data on the employment status of transplanted patients pre- and posttransplant as well as various bio-psycho-social variables related to the employment status

Evolution of depression pre-Tx (0), 6 and 12 months post-Tx, by employment status 12 months post-Tx.

<p>Evolution of depression pre-Tx (0), 6 and 12 months post-Tx, by employment status 12 months post-Tx.</p