Longitudinal prospective study on quality of life and psychological distress before and one year after liver transplantation.
BACKGROUND
The impact of liver disease and medical complications on quality of life (QOL) and psychological distress before and after liver transplantation (LT) is a matter of growing interest.


METHODS
In a longitudinal prospective study, perceived QOL (LEIPAD Quality of Life test) and psychological distress (Brief Symptom Inventory, BSI) were assessed in 25 cirrhotic patients when they were listed for LT and 1, 3, 6 and 12 months after LT. Patients were also evaluated for medical complications and blood levels of immunosuppressive agents.


RESULTS
Overall QOL and psychological distress improved significantly and rapidly in most domains from the first month and up to a year after LT. Medical complications and immunosuppressive agents did not correlate with any changes in QOL and psychological distress after LT. When patients were divided according to liver disease etiology: 1. HCV patients listed for LT had worse QOL levels than the group of patients as a whole or the alcoholic liver disease (ALD) patients; 2. HCV patients reported a significant improvement in QOL only 6 and 12 months after LT, and still suffered more psychological distress 12 months after surgery; 3. in ALD patients, overall QOL and psychological distress improved significantly at all follow-up points after LT; 4. HCV patients reported a worse QOL and greater psychological distress 1 and 3 months after LT than the group as a whole or the ALD patients (p < 0.05).


CONCLUSIONS
Liver transplantation improves QOL and psychological distress in most recipients, but not in the early stages after LT in patients transplanted for HCV cirrhosis.
Burra
P
P
Department of Surgical and Gastroenterological Sciences, University of Padua, Padua, Italy. burra@unipd.it
De Bona
M
M
Canova
D
D
Feltrin
A
A
Ponton
A
A
Ermani
M
M
Brolese
A
A
Rupolo
G
G
Naccarato
R
R
D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007558:Italy; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D018434:Sickness Impact Profile; D018709:Statistics, Nonparametric; D013315:Stress, Psychological; D016896:Treatment Outcome