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

Abstract

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.)

Estudo preliminar sobre a qualidade de vida e sintomatologia depressiva de pacientes em fase pré e pós-transplante hepático

“…Na literatura internacional, os vários estudos encontrados apontam para melhora da qualidade de vida desses pacientes, mas também para muitas dificuldades advindas das complicações clínicas e dos problemas emocionais adquiridos com o sofrimento na fase crônica da doença. Estes estudos também mostram que a depressão pode ter um papel importante na compreensão desses prejuízos da qualidade de vida [3][4][5][6][7][8][9][10][11][12][13] .…”

Health-related quality of life and psychological correlates in patients listed for liver transplantation

“…Nevertheless, extensive data on the well being of patients listed for a liver transplantation are currently not available. Levels of health-related quality of life (HRQoL) are known to be lower before liver transplantation compared to after [4][5][6][7][8][9][10][11], but there is little knowledge of the influence of psychological variables on the experienced HRQoL of these patients. Levels of anxiety and depression have been reported to be elevated in different transplant patient populations, including patients with liver disease [11].…”

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“…Many patients with ESLD face serious restrictions in their health-related quality of life, 12,13 with mental disorders, such as anxiety and depression, also occurring after these procedures. 14 Another important impairment of patients with ESLD is the presence of fatigue. 15 The term fatigue commonly expresses an everyday experience after physical exercise or inadequate sleep.…”