Two Cases of Living Donor Liver and Small Bowel Transplantation from Adult Donors to Paediatric Recipients

Background: Paediatric transplant recipients face barriers to school participation.There is sparse literature regarding this in intestinal transplant (ITx).Methods: For quality improvement cross-sectional school attendance data on all 16 current school-age transplant recipients from a single paediatric ITx centre was collected.11 families consented to a telephone conversation to provide qualitative data and 8 (with 1 transplant recipient) were available.All received a telephone call from a paediatrician who was not part of their transplant team.Results: 5/8 patients were male, aged 5-18years (median 13.5), 1-13years (median 5) post-ITx.6 patients were in school, 2 in vocational programs.In the month preceding data collection, 7 patients missed 0-5 schooldays, 1 missed every day.All reported medical appointments, illness and hospitalisation as absence reasons.5 reported absences related to shielding from others' illnesses.Some schools minimised risk with hygiene measures and parental information.When not done this exacerbated parental concerns, reducing attendance.Support varied between schools and local government areas.Some schools provided routine care, whilst some children required carers for medical needs. 1 parent reported lack of access to necessary care reduced attendance.3 reported difficulties obtaining accurate Education, Health, and Care Plans, affecting funding for support. 2 highlighted challenges with limited exam qualifications restricting further educational choices.Availability of alternative vocational options varied between areas. 1 reported bullying due to physical differences reduced attendance.