title: Life satisfaction and adverse effects in renal transplant recipients: a longitudinal analysis.
abstract: BACKGROUND
  Previous cross-sectional analyses have identified significant associations between quality of life (QOL), comorbidities and adverse effects in renal transplant recipients. This report examines the longitudinal relationship between adverse effects and QOL, with particular attention to the relative impact of adverse effects associated with immunosuppression.
  
  
  METHODS
  The Transplant Learning Center (TLC) is a program designed to improve QOL and preserve graft function in transplant recipients. Self-selected enrollees filled out questionnaires at roughly 3-month intervals. Each questionnaire included QOL scales developed for the program. Repeated measures multiple regression analysis was used to examine the relationship between the QOL scales, comorbidities, adverse effects, adjusting for other factors.
  
  
  RESULTS
  A total of 4247 TLC enrollees were included in the analysis, with a mean time since transplant of 5.1 yr. Comorbidities and adverse effects were common, with high blood pressure reported by 87% of respondents and unusual hair growth reported by 69.6%. In bivariate analysis, emotional/psychological problems and headaches had the largest impact on QOL. In multivariate analysis, emotional/psychological problems decreased sexual interest or ability, and headache had the largest adverse QOL effect.
  
  
  CONCLUSIONS
  We have identified QOL issues that have been previously underemphasized in transplant recipients. These findings open new areas of research to further explore and define these issues. They provide new opportunities for interventions to address factors adversely impacting QOL and to develop strategies to improve QOL in these patients. Clinicians should actively solicit information about adverse effects of medications, particularly information about sexual and relationship issues, when evaluating renal recipients. These issues should be taken into account when making therapeutic decisions.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, USA. matas001@tc.umn.edu
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Matas
authors.forename: R J
authors.initials: RJ
authors.lastname: Halbert
authors.forename: Mark L
authors.initials: ML
authors.lastname: Barr
authors.forename: J Harold
authors.initials: JH
authors.lastname: Helderman
authors.forename: Donald E
authors.initials: DE
authors.lastname: Hricik
authors.forename: John D
authors.initials: JD
authors.lastname: Pirsch
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Schenkel
authors.forename: Bonita R
authors.initials: BR
authors.lastname: Siegal
authors.forename: Honghu
authors.initials: H
authors.lastname: Liu
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Ferguson
mesh_terms: D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010549:Personal Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D007166:Immunosuppressive Agents