Despite an increasing quality of life after renal transplantation, the number of recipients undertaking paid professional work remains relatively low. Employment after kidney transplantation became a new important marker of clinically significant health recovery. Furthermore, for social and economic reasons, returning to work and participation in social life may be considered as an objective parameter that demonstrate the effectiveness of transplantation. The objectives of the following study were to evaluate the factors that determine resuming paid work after renal transplantation, to assess a patient's decision about returning to professional activity by comparative analysis of renal transplant recipients from Poland, Czech Republic and Germany, and to identify groups of patients exposed to professional exclusion in those EU countries. Five hundred renal transplant recipients from three EU countries were included into the study. The two main research methods used in the study were the SF-36 questionnaire, constructed and validated to assess the quality of life after kidney transplantation and a questionnaire constructed for the purposes of this study. Multifactorial analysis identified several risk factors associated with professional exclusions after kidney transplantation, namely young or advanced age, female gender, lack of education, place of residence in rural areas, long period of illness, and lack of occupational activity before transplantation. Despite the high standards of social care and rehabilitation support, patients in Germany failed to take up professional activity after kidney transplantation in more cases than those in Poland and Czech Republic. Surprisingly, the objective function of the kidney (creatinine level) and the multidimensional assessment of quality of life (SF-36 survey) did not have a significant association with the employment status after renal transplantation.

Department of Geriatrics Faculty of Medical Sciences Collegium Medicum in Bydgoszcz Nicolaus University 87 100 Torun Poland

Department of Immunology Transplantology and Internal Medicine Warsaw Medical University 02 091 Warsaw Poland

Department of Transplantology and General Surgery Faculty of Medicine Collegium Medicum in Bydgoszcz Nicolaus University 87 100 Torun Poland

Department of Transplantology and General Surgery Poznan District Hospital 60 479 Poznan Poland

Institute for Clinical and Experimental Medicine 140 21 Prague Czech Republic

Medizinische Klinik Mit Schwerpunkt Nephrologie und Internistische Intensivmedizin Charité Universitätsmedizin Berlin 10117 Berlin Germany

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