Current health status of patients who have survived for more than 15 years after liver transplantation.
BACKGROUND
Liver transplantation was started in our centre as early as 1979. We have studied the clinical outcome of patients surviving longer than 15 years, with special interest for the broad range of comorbidity and the self-perceived quality of life.


METHODS
All patients who underwent a liver transplantation at an adult age, between March 1979 and February 1991, and who had survived at least 15 years were eligible for the study. Data were collected from the medical records. Health-related quality of life was assessed using the Six-Dimensional EuroQol test.


RESULTS
The five-year survival of patients alive 15 years after transplantation was 78%. Thirty-seven patients are currently alive with a median follow-up of 18.8 years (range 15.0 to 26.8) after transplantation. Comorbidity consists predominantly of overweight (57%), osteoporosis (49%), de novo cancer (38%, mainly skin cancer), hypertension (38%), cardiovascular events (19%), diabetes mellitus (22%), cataract (24%), and renal clearance<50 ml/min (11%). The pattern of comorbidity seems to relate to the type of immunosuppression which consisted mainly of prednisolone and azathioprine. Quality of life was perceived as satisfactory (7 on a scale of 0 to 10). However, about half of the patients reported limitations in the domains mobility, usual activities and pain/discomfort. In addition a minority reported some anxiety or depression.


CONCLUSIONS
The outcome of liver transplantation in this early cohort of patients is fairly good. Improvements may be achieved by adaptations in the immunosuppressive regimen.
Department of Gastroenterology and Hepatology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
L
L
de Kroon
G
G
Drent
A P
AP
van den Berg
E B
EB
Haagsma
D000328:Adult; D000368:Aged; D015897:Comorbidity; D006304:Health Status; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000276:immunology / Q000523:psychology*; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D018434:Sickness Impact Profile; D017741:Survivors / Q000523:psychology*; D013995:Time
D007166:Immunosuppressive Agents