Study designs of evaluations included in the review
There were no explicit inclusion criteria for the study designs, although reviews were excluded. The included studies were descriptive and largely cross-sectional. There was one solely qualitative study involving structured interviews. Two studies did not have a comparison group and one compared pre- and post-transplant status.
Specific interventions included in the review
Studies where liver transplantation data for isolated orthotopic, auxiliary, or living related transplantation were reported separately were eligible for inclusion. Transplant procedures involving kidney or small intestine were excluded. No specific data were given on what procedures were included in the review.
Participants included in the review
Studies of children and adolescents from birth to 18 years of age were eligible for inclusion. The included studies comprised infants only, children only, adolescents only, and a mix of children and adolescents. The age ranged from 6 months to 23 years, and there was an approximately equal division of males and females. All patients received liver transplants between the years 1981 and 2002. Comparison groups comprised largely age-appropriate healthy or chronically ill populations.
Outcomes assessed in the review
Studies where patient or parent reports were available on at least two of the five HRQL domains of physical health, psychological functioning, social functioning, family functioning, or general well-being were eligible for inclusion. All but one of the studies included both physical and psychological health outcomes. Studies assessed outcomes using three to five of the HRQL domains. The included studies used eight different HRQL instruments plus four battery questionnaires. Approximately half of the studies used self-report and half relied solely upon parental responses.
How were decisions on the relevance of primary studies made?
One reviewer considered the titles and abstracts, following which two reviewers independently examined the selected full texts. Any disagreements were resolved by consensus.