title: Changes in quality of life after liver transplantation among adults. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Liver Transplantation Database (LTD).
abstract: Quality of life is an important factor to consider when assessing the value of liver transplantation. Using a large, prospective database of liver transplantation recipients from three clinical centers in the United States, we examined the quality of life of 346 adults before and 1 year after surgery. Five quality of life domains were evaluated (measures of disease, psychological distress and well-being, personal function, social/role function, and general health perception) with standardized questionnaires completed according to established protocol. The largest numbers of patients were distressed by fatigue and muscle weakness, both before transplantation and 1 year after surgery. Compared to baseline, recipients at follow-up noted fewer disease-related symptoms (P < .001) and lower levels of distress overall (P < .001). However, levels of distress due to excess appetite (P < .001), headaches (P = .02), and poor/blurred vision (P = .05) were more likely to increase than decrease. Although 57% to 64% of the recipients were distressed by each of the psychological conditions examined at follow-up, distress was more likely to decrease than increase (P < .001), and well-being was comparable to the general population. All measures of personal functioning improved significantly (P < .05). Fifty-eight percent of the patients prevented by their disease from going to work or school before transplantation were no longer so limited at follow-up. With the exception of marriage (P = .23), all facets of social/role functioning improved more often than worsened (P < .01). Perception of health improved remarkably, with 13.4 times as many recipients reporting improved health as reporting worse health (P < .001). We conclude that liver transplantation markedly improves the quality of life of patients with end-stage liver disease.
authors.affiliation: University of Pittsburgh, Department of Epidemiology Data Center, Graduate School of Public Health, PA, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Belle
authors.forename: M K
authors.initials: MK
authors.lastname: Porayko
authors.forename: J H
authors.initials: JH
authors.lastname: Hoofnagle
authors.forename: J R
authors.initials: JR
authors.lastname: Lake
authors.forename: R K
authors.initials: RK
authors.lastname: Zetterman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005221:Fatigue / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000523:psychology; D005260:Female; D006261:Headache / Q000523:psychology; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000523:psychology