Background: Renal transplantation is considered the first-choice method of renal replacement therapy for ESRD patients. Although renal transplantation brings many benefits to recipients, it is potentially associated with a number of drawbacks, which influence their health-related quality of life (HRQOL).

Purpose: The purpose of this study was to investigate the HRQOL of renal transplant recipients and its influencing factors. The relationships among transplant-related clinical factors, cognitive appraisal of health, perceived self-efficacy, perceived social support, coping, and HRQOL were examined using a theoretically derived model from Lazarus and Folkman’s (1984) Model of Stress and Coping.

Methods: Renal transplant recipients with functional kidney graft and more than 3 months after transplantation were recruited at a transplant follow-up clinic in Beijing. Standardized instruments were used to evaluate the variables. Data were analyzed using IBM SPSS Amos 21.0. Path analysis was used to examine the theoretically derived model.

Results: The mean scores of 202 renal transplant recipients for SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) were 48.18±9.67 and 47.61±6.75 respectively. Path analysis demonstrated that perceived self-efficacy had a significant direct effect on negative primary appraisal of health and physical HRQOL, and had both direct and indirect effects on acceptance-resignation coping strategies. Perceived social support had a direct effect on negative primary appraisal, and direct and indirect effect on acceptance-resignation coping strategies. Primary appraisal of health had a significant direct effect on coping strategies, physical and mental HRQOL. Confrontation and avoidance coping strategies had no significant direct effects on physical and mental HRQOL, while acceptance-resignation coping strategies had significant direct effect on mental HRQOL. Medication side effects had significant direct effects on primary appraisal of health and mental HRQOL.

Conclusion: HRQOL of renal transplant recipients is the outcome of a complex interplay between clinical factors, psychosocial factors, and behavior factors. Information from this study may help transplant professionals develop interventions to improve HRQOL of renal transplant recipients.