title: Impact of lung transplantation on recipient quality of life: a serial, prospective, multicenter analysis through the first posttransplant year.
abstract: BACKGROUND
  Quality of life (QOL) is an important but understudied outcome after lung transplantation. Previous cross-sectional, single-center studies suggest improved QOL, but few prior longitudinal multicenter data exist regarding the effect of transplantation on the patient’s QOL.
  
  
  METHODS
  We hypothesized that lung transplantation confers a 1-year QOL benefit in both physical and psychologic well-being; we further hypothesized that the magnitude of benefit would vary by sex, native disease, age, or type of transplant operation. To test these hypotheses, we conducted a secondary analysis using QOL data prospectively and serially measured with the Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36) in a multicenter cytomegalovirus prevention clinical trial. Linear mixed-effects models were used to assess the impact of transplantation on the recipient’s QOL.
  
  
  RESULTS
  Over the first year after lung transplantation, the SF-36 Physical Component Score significantly increased an average of 10.9 points from baseline levels (P < .0001). A positive benefit was observed for all native diseases; however, the magnitude varied slightly by native disease (P = .04) but not by sex (P = .35), age (P = .06), or transplant type (P = .30). In contrast, the SF-36 Mental Component Score did not change from baseline (P = .36) and remained well below population norms.
  
  
  CONCLUSIONS
  Our results demonstrate that lung transplantation confers clinically important QOL benefits in physical domains but not in psychologic well-being. A better understanding of the barriers to psychologic well-being after transplant is critical to enhancing the benefits of lung transplantation.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC. Electronic address: Ashley.finlen.copeland@duke.edu.
authors.forename: C Ashley
authors.initials: CA
authors.lastname: Finlen Copeland
authors.affiliation: North Carolina State University, Raleigh, NC.
authors.forename: David M
authors.initials: DM
authors.lastname: Vock
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Karen
authors.initials: K
authors.lastname: Pieper
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Mark
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Palmer
mesh_terms: D006305:Health Status Indicators; D006801:Humans; D016040:Lung Transplantation; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life