title: Liver transplantation and quality of life: relevance of a specific liver disease questionnaire.
abstract: OBJECTIVE
  A positive effect of liver transplantation on health-related quality of life (HRQOL) has been well documented in previous studies using generic instruments. Our aim was to re-evaluate different aspects of HRQOL before and after liver transplantation with a relatively new questionnaire the 'liver disease quality of life' (LDQOL).
  
  
  METHODS
  The LDQOL and the Short Form 36 (SF-36) questionnaires were applied to ambulatory patients, either in the transplant list (n=65) or after 6 months to 5 years of liver transplant (n=61). The aetiology of cirrhosis, comorbidities, model for end-stage liver disease (MELD) Child-Pugh scores and recurrence of liver disease after liver transplantation were analysed using the Mann-Whitney and Kruskall-Wallis tests.
  
  
  RESULTS
  In patients awaiting liver transplantation, MELD scores > or =15 and Child-Pugh class C showed statistically significant worse HRQOL, using both the SF-36 and the LDQOL questionnaires. HRQOL in pretransplant patients was found to be significantly worse in those with cirrhosis owing to hepatitis C (n=30) when compared with other aetiologies (n=35) in 2/7 domains of the SF-36 and in 7/12 domains of the LDQOL. Significant deterioration of HRQOL after recurrence of hepatitis C post-transplant was detected with the LDQOL questionnaire although not demonstrated with the SF-36. The statistically significant differences were in the LDQOL domains: symptoms of liver disease, concentration, memory and health distress.
  
  
  CONCLUSIONS
  The LDQOL, a specific instrument for measuring HRQOL, has shown a greater accuracy in relation to liver symptoms and could demonstrate, with better reliability, impairments before and after liver transplantation.
authors.affiliation: University of São Paulo, Surgery and Liver Transplant, Sao Paulo, São Paulo, Brazil.
authors.forename: Daniela R M
authors.initials: DR
authors.lastname: Gotardo
authors.forename: Edna
authors.initials: E
authors.lastname: Strauss
authors.forename: Maria-Cristina D
authors.initials: MC
authors.lastname: Teixeira
authors.forename: Marcel C C
authors.initials: MC
authors.lastname: Machado
mesh_terms: D000328:Adult; D001938:Brazil; D015897:Comorbidity; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000473:pathology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012008:Recurrence; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires