Effects of liver transplantation on health‐related quality of life in patients with primary biliary cholangitis

Abstract

Background Patients with primary biliary cholangitis (PBC) have decreased health‐related quality of life (HRQoL). Here, we investigate HRQoL in two cohorts of transplanted patients with PBC and compare their results to healthy subjects. Patients and Methods We used generic SF‐36 and disease‐specific PBC‐40 questionnaires to evaluate HRQoL in 26 patients with PBC (23 females, age 59.4 ± 5.7 years) before and after liver transplantation (LT), and in 107 patients with PBC (99 females, age 62.8 ± 6.7 years) who were previously transplanted. The control group was comprised of 60 healthy controls (55 females, age 54.6 ± 8.8 years). Results Health‐related quality of life improved after LT in 85% of PBC patients. The SF‐36 measure showed significant (all P < 0.05) improvements in the majority of domains after LT, and in the summary scores both physical and mental. We also documented significant improvements in pruritus and fatigue after LT (all P < 0.01). However, liver graft recipients had significantly worse physical functioning, physical role, and emotional role domains, and physical component score (all P < 0.001), as compared to healthy subjects. No differences in HRQoL were detected between patients evaluated after short and prolonged post‐LT periods (P > 0.05). Conclusion Liver transplantation substantially improves most aspects of life quality in PBC patients. Nevertheless, their HRQoL remains worse in comparison to healthy individuals, mainly in physical aspects.

Health-related quality of life, workability, and return to work of patients after liver transplantation

“…In accordance with findings in the literature, study participants reported moderately reduced HrQoL, primarily in terms of the physical component as compared to healthy controls [3][4][5]. Independent of the patients' age, the most substantial deficits, based on SF-36, were found in the dimensions of "role physical" and "social functioning."…”

“…This improvement seems to persist in the long term as overall quality of life scores remain higher up to 20 years afterward, and the psychosocial component even comes close to approximating the data reported for the healthy population [4]. Nevertheless, despite marked improvement compared to the preoperative status, physical functioning continues to be inferior to the general population [3][4][5]. These general findings of gain in HrQoL after LT may not extend to all patient groups, e.g., to patients with hepatocellular carcinoma (HCC).…”

Health‐related quality of life is dynamic in alcoholic hepatitis and responds to improvement in liver disease and reduced alcohol consumption

“…Our study extends these findings to AH. In fact, SF‐36 scores in our study population are comparable or lower than scores seen in prior studies of alcoholic and nonalcoholic cirrhosis including those with Child‐Pugh stage B cirrhosis and those awaiting liver transplant (Eshelman et al, 2010; Hansen et al, 2021; Janani et al, 2018; Krawczyk et al, 2018; Samala et al, 2020). Furthermore, our results also show extremely poor SF‐36 PC scores in those with the most severe manifestation of AH such as ascites and hepatic encephalopathy.…”

Vitamin-D Receptor-Gene Polymorphisms Affect Quality of Life in Patients with Autoimmune Liver Diseases

“…In general, little is known about the impact of VDR polymorphisms on the quality of patients' life since previous studies mostly focused on the prevalence of each polymorphism in autoimmune diseases but not on their relation with the clinical course of the disease [29]. Most studies on the quality of life in patients with PBC or AIH addressed relations between specific aspects of disease, such as fatigue, pruritus, depression, and quality of life after liver transplantation [7,[40][41][42][43][44][45][46][47][48][49] but not the impact of VDR gene polymorphisms.…”