Quality of life following liver transplantation: physical and functional recovery

Abstract

Traditionally health care outcomes have been evaluated by measuring immediate and long-term survival. This paper demonstrates the importance of quality of life as an alternative outcome indicator by considering two dimensions of quality of life and how they affect patients following liver transplantation. These two dimensions are physical recovery and functional recovery and they are considered by analysing the literature exploring quality of life following liver transplantation. Physical recovery is be subdivided into sleep, pain and mobility and functional recovery is subdivided into occupational rehabilitation and domestic rehabilitation.

Persistent fatigue in liver transplant recipients: a two‐year follow‐up study

“…In the general population, 15–35% of adults report frequent sleep quality disturbance (24). Previously, reported rates of sleep disturbances after LTx range from 14% to 45% (37–40), whereas 51% of our study patients reported sleep disturbance.…”

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

“…A statistical significance was reached in almost all SF‐36 categories with the exceptions of bodily pain and mental health where our study population scored similarly to the German reference population. Long‐term survivors after OLT presented, as mentioned above, a mental HRQOL comparable to that of the control population, probably as a result of coping with their disease [28], or of having managed to overcome the factor of bodily pain, which during the initial period after OLT causes great anxiety to the patient [29]. On the other hand, long‐term immunosuppressive therapy, nephrotoxicity of CNIs, cardiovascular and metabolic complications of corticosteroids and disease recurrence, especially in primary sclerosing cholangitis and primary biliary cirrhosis [30], hepatitis C [31], hepatocellular carcinoma [32] and alcoholic liver disease [33] might be some of the factors to blame for the lower scores of our study population in the above mentioned SF‐36 categories [13].…”

Sleep Disorders in Chronic Liver Disease

“…Reported rates of sleep disturbances after LT range from 14 to 45%. 104,105 In both cross-sectional studies and a longitudinal study with 2-year follow-up, fatigue remained a major issue after LT, and the level of fatigue did not appear to change over time, suggesting that fatigue is a chronic problem following LT. 106,107 In the longitudinal study, sleep quality, anxiety, and depression were significantly associated with fatigue severity. 107 In contrast, a study by Aadahl et al found that fatigue was less severe in patients who had undergone LT 4 to 5 years previously compared with more recently.…”