title: Outcome and quality of life in patients with polycystic liver disease after liver or combined liver-kidney transplantation.
abstract: In advanced stages of polycystic liver disease, often associated with polycystic kidney disease, a curative therapy is liver or combined liver-kidney transplantation. However, little is known about long-term outcome and quality of life. Between 1990 and 2003, 36 patients (32 female, 4 male) with polycystic liver or combined liver-kidney disease underwent liver (n = 21) or liver-kidney (n = 15) transplantation at our center. Main indications for liver transplantation were cachexia, muscle atrophy, loss of weight, recurrent cyst infections, portal hypertension, and ascites. Apart from clinical parameters, 2 anonymous questionnaires (standard short form 36 and self-designed) addressing quality of life and social status were evaluated. Five patients (14 %) died due to sepsis or myocardial infarction with pneumonia, all within 61 days after transplantation. The follow-up time of the remaining 31 patients ranged from 5 to 156 months, with a mean of 62 months. Of the 23 (74%) answered the questionnaires, 91% of patients felt "much better" or "better," only 9% felt "worse" than before, and 52% of patients participated in sports regularly. Fatigue, physical fitness, loss of appetite, and vomiting improved significantly after transplantation. Physical attractiveness and interest in sex increased as well. Professional occupation did not change for 71% of patients. Family situation before and after transplantation changed in 1 case only. Finally, 78% of patients said they would opt for transplantation again, while 17% were undecided; 1 patient would not repeat transplantation. In conclusion, patients with advanced polycystic liver or polycystic liver-kidney disease have an excellent survival rate and an improved quality of life after liver or combined liver-kidney transplantation.
authors.affiliation: Gastroenterology, Hepatology, and Endocrinology, Medical School of Hannover, Hannover, Germany. Gabriele.Kirchner@klinik.uni-regensburg.de
authors.forename: Gabriele I
authors.initials: GI
authors.lastname: Kirchner
authors.forename: Kinan
authors.initials: K
authors.lastname: Rifai
authors.forename: Tobias
authors.initials: T
authors.lastname: Cantz
authors.forename: Bjoern
authors.initials: B
authors.lastname: Nashan
authors.forename: Christoph
authors.initials: C
authors.lastname: Terkamp
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
authors.forename: Christian
authors.initials: C
authors.lastname: Strassburg
authors.forename: Hannelore
authors.initials: H
authors.lastname: Barg-Hock
authors.forename: Siegfried
authors.initials: S
authors.lastname: Wagner
authors.forename: Rainer
authors.initials: R
authors.lastname: Lück
authors.forename: Juergen
authors.initials: J
authors.lastname: Klempnauer
authors.forename: Michael P
authors.initials: MP
authors.lastname: Manns
mesh_terms: D000328:Adult; D000368:Aged; D003560:Cysts / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008107:Liver Diseases / Q000473:pathology / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome