Family roles and routines after pediatric liver transplantation: implications for quality of life and beyond.

The quality of life (QoL) of pediatric liver transplant (LT) recipients has been repeatedly shown to be impaired relative to healthy populations and other chronic illness groups (1–6). Recent studies have demonstrated that impairments in QoL persist 10–20 yr after transplant (7, 8). Despite growing recognition that pediatric LT recipients have lower QoL and require monitoring and support, little attention has been given to the impact childhood liver transplantation has on parents and families. Nearly a decade ago, a call was issued to include assessment of family functioning in the study of functional outcomes for pediatric LT recipients (4). Unfortunately, this research continues to be limited to few studies. Overall, families of pediatric LT recipients are not dysfunctional (9), yet aspects of family functioning may have important implications for adjusting to life after transplant.