Does Transplantation Produce Quality of Life Benefits?

Dew, Mary Amanda; Switzer, Galen E.; Goycoolea, Jean M.; Allen, Aishe S. B.S.; DiMartini, Andrea; Kormos, Robert L.; Griffith, Bartley P.

doi:10.1097/00007890-199711150-00006

Cited by 321 publications

(238 citation statements)

References 29 publications

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“…These researchers addressed the need to implement a standardized approach to assess and treat (i.e, pharmacologic interventions) psychologic distress immediately after transplant surgery and during the recovery phase. 2 There was a strong association between hope, mood states and MCS measures of QOL in the current study. A similar study in the heart transplant literature documented the association of hope (or positive expectations) with good mood, adjustment to illness and QOL, even in patients who experienced health setbacks.…”

Section: Discussionsupporting

confidence: 51%

“…results in increased distress and anxiety, [1][2][3][4] and a number of patients find themselves confronted with the difficult and unexpected task of adapting to a chronic physical condition after the surgery. 5 For this reason, care of the heart transplant patient has evolved from focusing solely on survival to improving emotional well-being and quality of life (QOL).…”

mentioning

confidence: 99%

“…10,11 Finally, the majority of studies on QOL after heart transplantation have included an insufficient number of women to allow for a generalization of results to female heart transplant recipients. 2 Considering the fact that female gender is an independent risk factor for increased prevalence and risk of depression and anxiety-related disorders after heart transplant, 4 additional research that examines mood states and QOL in female recipients is needed to better understand psychosocial problems in this high-risk population.…”

mentioning

confidence: 99%

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Hope, mood states and quality of life in female heart transplant recipients

Evangelista

Doering

Dracup

et al. 2003

The Journal of Heart and Lung Transplantation

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Objective:The role of hope on mood states and quality of life (QOL) in heart transplant recipients has not been examined previously. This exploratory study was done to describe levels of hope, mood states and QOL; examine relationships between these variables and demographic characteristics; and identify predictors of QOL in female heart transplant recipients. Methods:Fifty women from a single heart transplant clinic were asked to complete the Herth Hope Index (HHI), Multiple Affect Adjective Checklist (MAACL) and SF-12 (which produces a physical component summary [PCS] and a mental component summary [MCS]). Descriptive statistics, Pearson correlations, and stepwise multiple regression were used to analyze the data. The level of statistical significance was set at 0.05. Results:Patients on average were 54.7 Ϯ 13.0 years of age and had undergone heart transplantation 5.2 Ϯ 4.4 years prior to study participation. Patients reported experiencing moderately low hope, and moderately high anxiety, depression and hostility. They also exhibited low levels of QOL as reflected in their low PCS and MCS scores. There was a strong positive association between hope, mood states and MCS (p ϭ 0.001). In a multiple regression model, age, hope and depression accounted for 69% of the variance in the MCS. Conclusions:The study supports the strong association between hope, mood states and the MCS of QOL in female heart transplant recipients. Hope was an independent predictor of mood states and QOL. This finding suggests that interventions directed at fostering hope among heart transplant recipients may be the key to improving their QOL. J Heart Lung Transplant 2003;22:681-686.Indi viduals who undergo heart transplantation may progress from a terminal state of heart failure to a comparatively active lifestyle. However, heart transplantation is a major surgical intervention that From the

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Section: Discussionsupporting

confidence: 51%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Hope, mood states and quality of life in female heart transplant recipients

Evangelista

Doering

Dracup

et al. 2003

The Journal of Heart and Lung Transplantation

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“…Despite an increasing number of prospective studies, only a few are longitudinal. 3 The purpose of this single-center prospective longitudinal study was to assess the impact of LT on French recipients' QOL 1 year after the surgery and to document how the liver recipients fared in relation to a sample from the general population with respect to five QOL domains: measures of disease, psychological distress and well-being, personal function, social and role function, and general health perception. Validation of the French version of the National Institute of Diabetes and Digestive and Kidney Disease-Pittsburg, USA (NIDDK) questionnaire was achieved.…”

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confidence: 99%

Longitudinal prospective evaluation of quality of life in adult patients before and one year after liver transplantation

Karam

Castaing

Danet

et al. 2003

Liver Transplantation

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We assessed the impact of liver transplantation (LT) on the quality of life (QOL) of French recipients 1 year after surgery. A French version of the questionnaire used by the National Institute of Diabetes and Digestive and Kidney Disease-Pittsburg, USA (NIDDK), was validated by the back-translation method. Five QOL domains were evaluated: measures of disease, psychological distress, personal function, social function, and general health perception. Patients enrolled onto the waiting list completed the questionnaire before and 1 year after LT. Respondents were age-and gender-matched with healthy subjects recruited from the general population (GP). One year after LT, the analysis of data from 67 consecutive patients showed dramatic improvement in the five domains. Compared with baseline, patients noted fewer disease-related symptoms (P < .0001) and lower level of distress overall (P < .001). However, levels of distress caused by excess appetite (P < .01), trembling (P < .05), and headaches (P ‫؍‬ .06) were more likely to increase than decrease. Twenty-five percent of patients prevented by their disease from going to work before LT were no longer so limited at 1-year follow-up. General health perception improved remarkably, with seven times as many recipients reporting improved health as reporting worse health. A correlation was found between the pretransplantation severity of cirrhosis and the social and role function after LT (P < .05). In summary, the French version of the NIDDK questionnaire seems to be reliable. The results of transplant recipients were generally close to those of the general population. Although it is not a true return to normal status, it approaches it. (Liver Transpl 2003;9:703-711.)

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“…Les contraintes liées au traitement immunosuppresseur et à la surveillance médicale sont relativement faibles [25]. Malgré cela, seule une minorité des malades peut reprendre une activité professionnelle en raison d'une interruption prolongée de celle-ci avant la transplantation et de la difficulté à trouver un emploi adapté.…”

Section: Qualité De Vieunclassified

Transplantation hépatique chez l’adulte

Durand

Belghiti

2005

Med Sci (Paris)

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La transplantation hépatique reste l'unique moyen de pallier durablement les insuffisances hépatiques graves et leurs conséquences. En effet, il n'existe pas de technique de suppléance artificielle des fonctions hépa-tiques comparable à l'hémodialyse pour l'insuffisance rénale. Bien que la transplantation soit une intervention chirurgicale lourde, les progrès réalisés dans la sélection des candidats, les techniques chirurgicales et les traitements immunosuppresseurs font que le taux de survie à un an excède en moyenne 80 %. Entre 700 et 800 transplantations hépatiques sont réalisées chaque année en France. Cependant, le manque de donneurs conduit au décès de 5% à 15% des candidats à la transplantation pendant la période d'attente. Critères de sélection des receveursLe manque de donneurs conduit à sélectionner les candidats qui ont les meilleures chances de succès. La plupart des équipes écartent les candidats pour lesquels les chances de succès sont faibles (inférieures à 50% à un an), considérant qu'il serait illogique d'attribuer un greffon à un malade ayant un pronostic réservé, alors que ce greffon aurait pu être attribué à un receveur ayant un meilleur pronostic. Maladies chroniques non tumorales du foieLes maladies parenchymateuses chroniques (cirrhoses) représentent les indications les plus fréquentes de la transplantation hépatique. Quelle que soit l'étiologie de la cirrhose, une transplantation est envisagée lorsqu'il existe à la fois une insuffisance hépatique sévère (taux MEDECINE/SCIENCES 2005 ; 21 : 89-94 REVUES DOSSIER TECHNIQUE> La transplantation hépatique permet de traiter les formes les plus graves de cirrhose, ainsi que certaines tumeurs malignes du foie (carcinomes hépatocellulaires de petite taille), avec une espé-rance de vie dépassant respectivement 70% et 60% à cinq ans. Les traitements immunosuppresseurs actuels permettent à la fois de prévenir le rejet chronique dans plus de 90% des cas et d'assurer le plus souvent une excellente qualité de vie. Le facteur limitant principal est le manque de donneurs en état de mort cérébrale. En effet, malgré une sélection des candidats ayant les meilleures chances de succès, l'attente d'un greffon dure habituellement plusieurs mois et la mortalité en liste d'attente est de 10% à 15%. Le manque de donneurs a conduit à développer des alternatives à la transplantation conventionnelle, dont les principales sont les techniques du donneur vivant et du foie partagé. La transplantation par donneur vivant peut s'appliquer à environ 20% à 30% des candidats. Le greffon, bien qu'il soit initialement de petite taille, se régénère et retrouve une taille normale en quelques semaines. Les résultats en termes de survie sont équivalents à ceux de la transplantation par donneur cadavérique. Le risque pour le donneur doit être inférieur à 1%, ce qui conduit à une sélection très attentive. Les donneurs ne peuvent être que des parents directs ou le conjoint. La technique du foie partagé repose sur le partage d'un greffon cadavérique en deux parties autonomes attribuées...

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Does Transplantation Produce Quality of Life Benefits?

Cited by 321 publications

References 29 publications

Hope, mood states and quality of life in female heart transplant recipients

Hope, mood states and quality of life in female heart transplant recipients

Longitudinal prospective evaluation of quality of life in adult patients before and one year after liver transplantation

Transplantation hépatique chez l’adulte

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