title: Quality of life and performance status before and after small intestinal transplantation.
abstract: BACKGROUND
  Intestinal transplantation (IT) is considered for patients with irreversible intestinal failure who develop life-threatening complications of parenteral nutrition or have extensive intra-abdominal disease requiring evisceration. Developing indications may include quality of life (QOL) considerations and therefore assessment of QOL and performance status (PS) after IT is important. We report QOL and PS before and after IT in our cohort.
  
  
  METHODS
  Consecutive patients undergoing IT were included. QOL was assessed using the generic 36-item short form survey (SF 36) tool at assessment and 6-month intervals post-transplantation. Performance was assessed using a visual analogue scale (VAS), Karnofsky scale (KS), and the Eastern Cooperative Oncology Group scale at three time points: premorbidly, at listing, and after transplantation.
  
  
  RESULTS
  Data were available for 21 patients. There were 11 complete SF 36 datasets and 15 performance scores. Data were not available from 3 patients, and the overall response rate was 62%. Overall, there was a trend for improved SF 36 scores post-transplantation in approximately half of the patients with scores remaining stable in approximately one third. The results of the SF 36 significantly improved in 1 patient (P < .01). After IT, 66% of patients had better VAS scores than at listing and >75% of patients scored better or the same in KS compared to status at listing. However, PS after IT did not improve to premorbid levels.
  
  
  CONCLUSIONS
  We found a trend for QOL scores to improve in approximately half of the patients compared to their status at listing, remain static in approximately one third, and a minority experience a decline. For the majority, differences were not statistically significant. PS of patients after transplantation is equal or better than that at listing in 75%, but rarely reaches that of the premorbid status. Longer-term studies are needed and may reveal progressive improvement.
authors.affiliation: Department of Gastroenterology, Addenbrooke's, Cambridge University Hospital NHS Trust, UK.
authors.forename: C
authors.initials: C
authors.lastname: Pither
authors.affiliation: Department of Gastroenterology, Addenbrooke's, Cambridge University Hospital NHS Trust, UK.
authors.forename: S
authors.initials: S
authors.lastname: Duncan
authors.affiliation: Department of Gastroenterology, Addenbrooke's, Cambridge University Hospital NHS Trust, UK.
authors.forename: R
authors.initials: R
authors.lastname: Gao
authors.affiliation: Department of Surgery, Addenbrooke's, Cambridge University Hospital NHS Trust, UK.
authors.forename: A
authors.initials: A
authors.lastname: Butler
authors.affiliation: Department of Gastroenterology, Addenbrooke's, Cambridge University Hospital NHS Trust, UK.
authors.forename: S
authors.initials: S
authors.lastname: West
authors.affiliation: Lennard Jones Intestinal failure centre, St Mark's Hospital, Harrow, London, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Gabe
authors.affiliation: Department of Gastroenterology, Addenbrooke's, Cambridge University Hospital NHS Trust, UK. Electronic address: stephen.middleton4@nhs.net.
authors.forename: S J
authors.initials: SJ
authors.lastname: Middleton
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome