Kidney Transplant Recipients Able to Find Stable Work Post Surgery

The proportion of people who underwent a kidney transplant in The Netherlands were able to work, and well, according to a new report published in Clinical Journal of the American Society of Nephrology estimated.

This study also found that these patients functioned better at work after the surgery compared with before the transplant.

The study used data from the TransplantLines Biobank and Cohort study, which were collected from June 2015 to May 2021. Participants were invited to participate if they were adult solid organ transplant recipients or donors. Kidney transplant recipients with a functioning allograft and potential kidney donors were included.

Data on work were obtained through self-formulated questions, with work functioning measured using the Work Role Functioning Questionnaire (WRFQ). Adverse effects of immunosuppressive therapy also were assessed with a questionnaire.

Data from the WRFQ were available for 668 kidney transplant recipients, 246 potential kidney donors, and 553 community-dwelling employed adults. Adults with a transplant kidney received the organ from a living donor more frequently and underwent the procedure on a preemptive basis more frequently vs those who received a kidney transplant and did not fill out the questionnaires. The mean (SD) age of the group was 51 (11) years, median (IQR) time after transplantation was 3 (2-10) years, and 59% of participants were men.

The prevalence of men was lower in the potential kidney donors group (43%) and higher in community-dwelling adults (70%), and the mean age was higher among potential kidney donors and lower in community-dwelling employed adults, at 53 (9) and 45 (11) years.

Fifty-six percent of the participants who underwent a kidney transplant were employed compared with 79% of the potential kidney donors, with 62% of employed men and 48% of employed being transplant recipients. Kidney transplant recipients were most often employed on a permanent contract (72%), worked more than 32 hours a week (58%), and had mentally demanding tasks (44%). Eight percent reported sickness-related absence at the time of inclusion in the study, with 17% receiving a supplementary disability pension as well.

The median (IQR) total score of the WRFQ was lower compared with employed potential kidney donors, at 91 (76-98) vs 94 (85-99), but it was higher compared with community-dwelling adults who were employed, whose score was 88 (79-95).

Twenty-four percent, 23%, and 53% of the kidney transplant recipients reported low, medium, and high work functioning, respectively. Of the entire work time in patients who underwent kidney transplants, work scheduling demands were met a median of 94% (63%-100%), output demands were met a median of 88% (63%-100%), physical demands were met 100% (88%-100%), mental and social demands were met 96% (82%-100%), and flexibility demands were met 95% (85%-100%).

There were some limitations to this study. Causal relationships could not be assessed due to the observational study design, and selection bias favoring healthy patients was possible. Causes of unemployment and how many kidney transplant recipients were unemployed prior to transplant also were not available in any data.

Reference

Knobbe TJ, Kremer D, Abma FI, et al. Employment status and work functioning among kidney transplant recipients. Clin J Am Soc Nephrol. Published online September 26, 2022. doi:10.2215/CJN.05560522