Quality of life in adult survivors beyond 10 years after liver, kidney, and heart transplantation

Karam, Vincent; Gasquet, Isabelle; Delvart, V.; Hiesse, C; Dorent, Richard; Danet, Colette; Samuel, Didier; Charpentier, B; Gandjbakhch, I; Bismuth, H; Castaing, Denis

doi:10.1097/01.tp.0000092955.28529.1e

Cited by 151 publications

(143 citation statements)

References 17 publications

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“…The response rate to the survey of ϳ60% is somewhat lower than reported in shorter term studies of QOL in liver transplant patients. 9 However, the nonresponders in our study did not differ significantly from the responders in terms of their demographic and clinical details. The reasons for the low response rate are not clear, although it may be of relevance that approved ethical practice in the United Kingdom allows only a single follow-up to the initial postal invitation and does not encourage telephone or further postal reminders.…”

Section: Discussionmentioning

confidence: 55%

“…The authors reported reduced physical functioning in liver transplant recipients, with the QOL approaching that of the general population at 1 to 2 years but then 9 we sought to correlate reduced QOL (physical function) with a range of clinical variables. [9][10][11][12][13][14][15][16] Age, female gender, and osteoporosis showed the best correlation with reduced physical functioning and bodily pain. Age greater than 60 years tends to restrict personal functioning in the immediate posttransplant period 4,17 and is associated with increased mortality at 5 and 10 years after transplantation 18 ; the cause of death is often unrelated to the original liver disease or transplantation procedure.…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge, there is only 1 previous study that has evaluated QOL on patients in the longer term (Ͼ10 years) following liver transplantation. 9 The previous study 9 assessed patients from 3 centers using the French version of the National Institute of Diabetes and Digestive and Kidney Diseases instrument and addressed the issue of comparative QOL among kidney, liver, and heart recipients. The authors reported reduced physical functioning in liver transplant recipients, with the QOL approaching that of the general population at 1 to 2 years but then 9 we sought to correlate reduced QOL (physical function) with a range of clinical variables.…”

Section: Discussionmentioning

confidence: 99%

“…9 The previous study 9 assessed patients from 3 centers using the French version of the National Institute of Diabetes and Digestive and Kidney Diseases instrument and addressed the issue of comparative QOL among kidney, liver, and heart recipients. The authors reported reduced physical functioning in liver transplant recipients, with the QOL approaching that of the general population at 1 to 2 years but then 9 we sought to correlate reduced QOL (physical function) with a range of clinical variables. [9][10][11][12][13][14][15][16] Age, female gender, and osteoporosis showed the best correlation with reduced physical functioning and bodily pain.…”

Section: Discussionmentioning

confidence: 99%

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Quality of life up to 30 years following liver transplantation

et al. 2008

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Liver transplantation provides a return to a satisfactory quality of life (QOL) for the majority of patients in the short to medium term (first 5 years), but there is very little information on the QOL in the longer term and the factors influencing it. We therefore undertook a single-center cross-sectional analysis to determine QOL in patients 10 or more years after liver transplantation. All liver transplant recipients who were followed up at the Cambridge Transplant Unit for 10 or more years (transplanted between 1968 and 1994) and resident in the United Kingdom were asked to complete by post the Short Form 36 version 2 and the Ferrans and Powers questionnaires to evaluate their QOL. Univariate and multivariate analysis were performed to assess the relationship between a range of clinical parameters and QOL. One hundred two patients were invited to participate, and 61 (59.8%) responded. Overall, the patients reported a satisfactory QOL. On the Ferrans and Powers questionnaire, the patients had a mean Quality of Life Index score of 24.5. Factors associated with reduced physical functioning were age Ͼ 50 years at transplantation, female gender, and recurrence of the primary liver disease. On the Short Form 36 version 2 questionnaire, recipients had reduced physical functioning but normal mental health parameters in comparison with the normal population. Age Ͼ 60 years at the time of survey, female gender, and posttransplant complications were associated with reduced physical functioning. In conclusion, patients 10 or more years after liver transplantation generally have a good QOL, although physical functioning is reduced. Addressing issues such as recurrent disease and posttransplant problems such as osteoporosis may help to improve long-term QOL.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Quality of life up to 30 years following liver transplantation

et al. 2008

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“…Given the extremely high cost of lifelong antirejection therapy, a current challenge consists of devising management strategies that lower the expenses of transplantation without having an impact on clinical outcomes. In addition to patient and graft survival rates, it has been shown that improved quality of life is an important outcome measure after organ transplantation in addition to acute rejection and infection rates; these outcomes are important in determining the safety and efficacy of immunosuppressive regimens and function as a guide for other therapeutic choices (Karam et al 2003). This occurs owing to the fact that patients are now informed about the results and outcomes achieved with transplantation from which they not only expect to be healed, but also achieve similar quality of life as nontransplant individuals.…”

Section: The Pursuit Of An Immunosuppression-free Statementioning

confidence: 99%

Will Regenerative Medicine Replace Transplantation?

Orlando

Söker

Stratta

et al. 2013

Cold Spring Harbor Perspectives in Medicine

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Recent groundbreaking advances in organ bioengineering and regeneration have provided evidence that regenerative medicine holds promise to dramatically improve the approach to organ transplantation. The two fields, however, share a common heritage. Alexis Carrel can be considered the father of both regenerative medicine and organ transplantation, and it is now clear that his legacy is equally applicable for the present and future generations of transplant and regenerative medicine investigators. In this review, we will briefly illustrate the interplay that should be established between these two complementary disciplines of health sciences. Although regenerative medicine has shown to the transplant field its potential, transplantation is destined to align with regenerative medicine and foster further progress probably more than either discipline alone. Organ bioengineering and regeneration technologies hold the promise to meet at the same time the two most urgent needs in organ transplantation, namely, the identification of a new, potentially inexhaustible source of organs and immunosuppression-free transplantation of tissues and organs.

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Regenerative medicine, organ bioengineering and transplantation

Edgar

Porter

et al. 2020

British Journal of Surgery

143

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Background Organ transplantation is predicted to increase as life expectancy and the incidence of chronic diseases rises. Regenerative medicine‐inspired technologies challenge the efficacy of the current allograft transplantation model. Methods A literature review was conducted using the PubMed interface of MEDLINE from the National Library of Medicine. Results were examined for relevance to innovations of organ bioengineering to inform analysis of advances in regenerative medicine affecting organ transplantation. Data reports from the Scientific Registry of Transplant Recipient and Organ Procurement Transplantation Network from 2008 to 2019 of kidney, pancreas, liver, heart, lung and intestine transplants performed, and patients currently on waiting lists for respective organs, were reviewed to demonstrate the shortage and need for transplantable organs. Results Regenerative medicine technologies aim to repair and regenerate poorly functioning organs. One goal is to achieve an immunosuppression‐free state to improve quality of life, reduce complications and toxicities, and eliminate the cost of lifelong antirejection therapy. Innovative strategies include decellularization to fabricate acellular scaffolds that will be used as a template for organ manufacturing, three‐dimensional printing and interspecies blastocyst complementation. Induced pluripotent stem cells are an innovation in stem cell technology which mitigate both the ethical concerns associated with embryonic stem cells and the limitation of other progenitor cells, which lack pluripotency. Regenerative medicine technologies hold promise in a wide array of fields and applications, such as promoting regeneration of native cell lines, growth of new tissue or organs, modelling of disease states, and augmenting the viability of existing ex vivo transplanted organs. Conclusion The future of organ bioengineering relies on furthering understanding of organogenesis, in vivo regeneration, regenerative immunology and long‐term monitoring of implanted bioengineered organs.

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Quality of life in adult survivors beyond 10 years after liver, kidney, and heart transplantation

Abstract: The QOL beyond 10 years after liver, heart, and kidney transplantation is quite similar to the GP, with Kidney-R starting out as the worst, Heart-R as intermediate, and Liver-R the best.

Cited by 151 publications

References 17 publications

Quality of life up to 30 years following liver transplantation

Quality of life up to 30 years following liver transplantation

Will Regenerative Medicine Replace Transplantation?

Regenerative medicine, organ bioengineering and transplantation

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