Paediatric kidney transplant and school life: a qualitative study of children's academic experiences in Lahore, Pakistan.

Abstract

Paediatric kidney transplantation, while life-saving, presents significant academic challenges for children. Frequent hospitalisations, medical treatments and the psychosocial impact of chronic illness can severely disrupt educational trajectories. This study aimed to explore the post-transplant academic experiences of children from the perspective of their parents. A qualitative phenomenological study. Data were collected through in-depth, semistructured interviews and analysed using inductive thematic analysis. The study was conducted in Lahore, Pakistan, with participants recruited from the registry of the Punjab Human Organ Transplantation Authority (PHOTA). Thirteen parents of children who had undergone a kidney transplant and were enrolled in a formal school. Five major themes emerged from the analysis: (1) academic disruption and coping, detailing declines in performance and motivation alongside efforts to maintain engagement; (2) cognitive fatigue and emotional strain, encompassing reduced focus, memory difficulties and psychological distress; (3) school attendance, participation and support, highlighting frequent absenteeism, limited engagement in activities, and the critical role of institutional flexibility; (4) social identity and peer exclusion, revealing fears of stigma, self-isolation and misunderstanding from peers and (5) navigating the future, reflecting parental anxieties about long-term educational and career prospects alongside adaptive hope. The findings underscore that formal support systems in schools and healthcare settings are currently underdeveloped to meet these children's complex needs. This study illuminates the profound and multifaceted academic challenges faced by children after kidney transplantation. The results emphasise that a transplant is not merely a medical event but a life-altering experience with significant educational consequences. There is a critical need for integrated, targeted interventions that provide robust psychological support, flexible educational policies and comprehensive school reintegration programmes to ensure these children can achieve their full academic and personal potential.