Health-related quality of life in adult transplant recipients more than 15 years after orthotopic liver transplantation

Abstract

Summary With continuously rising survival rates following orthotopic liver transplantation (OLT), health‐related quality of life (HRQOL) of transplant recipients becomes increasingly important. Recipients more than 15 years after OLT were studied retrospectively. HRQOL in 104 adult liver transplant recipients surviving more than 15 years after OLT was assessed using the German Version of the 36‐Item Health Survey (SF‐36). Liver transplant recipients surviving more than 15 years after OLT scored lower in all categories of SF‐36 revealing a poor HRQOL in comparison to the German reference population. A statistical significance was reached in almost all SF‐36 categories with the exceptions of mental health and bodily pain, where our study population scored similarly to the reference population. Job rehabilitation after OLT had a positive effect on HRQOL. Patients who returned to their job during the first year after OLT scored significantly higher in the SF‐36 categories of physical functioning and role physical. Marital status and the immunosuppression used didn't affect HRQOL as there was no statistical significance reached in any of the comparisons performed. More than 15 years after OLT, long‐term survivors present a poor HRQOL comparable to the reference population. Occupational rehabilitation was the only factor shown to positively influence long‐term HRQOL.

Quality of life and psychiatric disorders before and one year after liver transplantation

“…Moreover, when new immunosuppressive agents like rapamycin or mycophenolate mofetil are used as monotherapies or in combination, they are known to decrease the common side effects. Kousoulas et al [20] evaluated the quality of life of adult LT recipients who survived for more than 15 years. They indicated no statistically significant finding when comparisons just after LT or in the long term were carried out regarding any of the SF-36 subscales between recipients taking CNI-associated or non CNI-associated immunosuppression.…”

Funcionamiento biopsicosocial entre pacientes cirróticos en distin-tas etapas del proceso de trasplante y su comparación con trasplantados hepáticos.

“…30, nº 1 (enero) dicts negative post-transplant outcomes (Kelly et al, 2006;Zipfel et al, 2002). On the other hand, even in the posttransplant phase, because these patients do not achieve the well-being levels of the general population (Estraviz et al, 2007;Kousoulas et al, 2008) and mental health impairment predicts worse daily functioning -by means of fatigue- (Van Ginneken et al, 2010) and mortality after transplant (Pérez-San-Gregorio, Martín-Rodríguez, Galán-Rodríguez, & Borda-Más, 2009). Likewise, if the psychological complications at the pre-waiting-list-study phase are identified and treated, future disorders will be prevented in next stages such as at the waiting-list and post-transplant phases.…”

“…For the past decades, this intervention has shown relevant advances, with very satisfactory results in terms of survival and quality of life (Forsberg, Bäckman, & Svensson, 2002;Karam et al, 2003;Ripoll & Bañares, 2008). However, most investigations of quality of life among transplant recipients conclude that these patients' quality of life does not reach the levels of the general population (Sumskiene, Sumskas, Petrauskas, & Kupcinskas, 2006;Taylor, Franck, Gibson, & Dhawan, 2005), not even 15 years after the surgical intervention (Kousoulas et al, 2008).…”

Lebertransplantation

“…Die sich ausweitenden diagnostischen Möglichkeiten der modernen Hepatologie führen dazu, dass Indikationen ausgeweitet werden und damit der Druck auf die Wartelisten steigt. Ergebnisse hängen aber nicht nur von den Spezifika der zur Indikation führenden Erkrankung ab [7,10,17,18], sondern werden auch von den Kriterien der Aufnahme auf die Warteliste und der damit zuerkannten Priorität beeinflusst [4]. Der Wechsel von einer auf dem Child-Turcotte-Pugh-System basierenden Allokation hin zum "model of end stage liver disease" (MELD) in 2006 [15] …”