Fatigue and physical function after orthotopic liver transplantation

Abstract

Over the last two decades, orthotopic liver transplantation (OLT) has become an established treatment for acute and chronic liver failure. OLT impacts not only on survival, but also on health-related quality of life. This study was undertaken to describe the self-rated health of Danish liver transplant recipients, compare their self-rated health against that of the general population, and to investigate associations between sex, age, diagnosis, time after OLT, and postoperative physical function and fatigue. All adult surviving liver transplant recipients who underwent OLT in Copenhagen, Denmark, from 1990 to 1998 (n ‫؍‬ 154) were contacted by mail and asked to complete a selfadministered questionnaire. The questionnaire contained the 36-Item Short Form Health Survey, the Multidimensional Fatigue Inventory, the Hospital Anxiety and Depression Scale, and questions on marital status, education, and work. The response rate was 84.4% (n ‫؍‬ 130). Liver transplant recipients reported poorer self-rated health than the general population in physical, but not in mental, health areas. One health aspect, fatigue, was investigated in great detail. This study found that liver transplant recipients experienced physical, rather than mental, fatigue. Diagnosis was found to be a predictor of postoperative physical function and fatigue because patients with an alcoholic or cryptogenic cirrhosis background had significantly poorer physical function and experienced more physical fatigue than liver transplant recipients with other diagnoses. Work status and survival time after OLT had significant effects on postoperative physical function and fatigue. Working and having undergone transplantation 4 to 5 years previously were associated with significantly better physical function and less physical fatigue than not working and having undergone transplantation 1 to 3 years previously. This study suggests that liver transplant recipients experience physical, rather than mental, impairment and fatigue and that diagnosis, work status, and survival time after OLT are associated with physical function and fatigue. (Liver Transpl 2002;8:251-259.)

Physical and psychological attributes of fatigue in female heart transplant recipients

“…8 Likewise, physical and emotional function in liver transplant patients decreased significantly with age. 19 We also found an association between employment status and fatigue; unemployed women experienced more fatigue than women who continued to work. A sense of control associated with working may provide a plausible explanation for this finding.…”

“…Work status after liver transplant was also associated with post-operative functional status and fatigue. 19 All of these proposed explanations require further testing in future research.…”

Fatores de risco para a falência do transplante ortotópico de fígado no Rio Grande do Sul, Brasil

“…O transplante hepático é o tratamento de eleição para doenças do fígado de evolução progressiva, irreversível e terminal que, com terapia conservadora, apresentam mortalidade de 70% ao ano 1,2,3 . Esse procedimento, embora de custo econômico alto (no Brasil, aproximadamente, US$ 22,000 de acordo com a Portaria GM n. 92 4 e Portaria GM n. 1.117 5 , ambas de 2001), tem permitido a reintegração de 68% dos indivíduos às atividades habituais, retribuindo à sociedade o investimento 6,7 .…”

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“…3 Positive effects of regular exercising have been observed in subjects after myocardial infarction and neoplastic diseases. [4][5][6] Seven-Day Physical Activity Recall Questionnaire (PAR) assesses both physical and work-related activity. This semistructured assessment focuses on these activities evaluated during the 7 days prior to the interview.…”