title: Health-related quality of life may improve after transplantation in pancreas-kidney recipients.
abstract: Pancreas-kidney transplantation (PKT) may significantly improve quality of life (HRQOL) in patients with type 1 diabetes. We have assessed the changes felt by PKT patients, using the Gastrointestinal Quality of Life Index (GIQLI) and EuroQol-5D questionnaires. Patients were asked to compare how their HRQOL had changed from pre-transplantation to the last visit. The 60 men and 66 women enrolled had a mean follow-up of five yr; 84.1% with both grafts, 15.9% with one graft functioning. In all domains of EuroQol-5D scores improved after PKT, as well as the visual analogue scale health state (from 38% to 84%, p < 0.001; effect size 3.34). In GIQLI, physical function was felt better after PKT than before (14.83 ± 3.86 vs. 7.86 ± 4.43, p < 0.001; effect size 1.68); the same was observed for psychological status, social function, and GI complaints. Concerning the burden of medical treatment, the score significantly improved (from 1.31 to 3.63, p < 0.001, effect size 2.02). The rate of unemployed patients decreased after PKT (from 50.8% to 36.5%, p < 0.001). Multivariate analysis showed that having only one functioning graft was associated with worse HRQOL scores (B = -5.157, p = 0.015). In conclusion, for all assessed domains, patients reported a significant improvement in HRQOL after PKT. Maintenance of the two grafts functioning predicted higher improvement of HRQOL scores.
authors.affiliation: Nephrology Department, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal; Transplantation Department, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Institute of Biomedical Sciences Abel Salazar, University Hospital de Santo António, University of Porto, Porto, Portugal.
authors.forename: La Salete
authors.initials: LS
authors.lastname: Martins
authors.forename: Cristina
authors.initials: C
authors.lastname: Outerelo
authors.forename: Jorge
authors.initials: J
authors.lastname: Malheiro
authors.forename: Isabel M
authors.initials: IM
authors.lastname: Fonseca
authors.forename: António C
authors.initials: AC
authors.lastname: Henriques
authors.forename: Leonídio S
authors.initials: LS
authors.lastname: Dias
authors.forename: Anabela S
authors.initials: AS
authors.lastname: Rodrigues
authors.forename: António M
authors.initials: AM
authors.lastname: Cabrita
authors.forename: Irene L
authors.initials: IL
authors.lastname: Noronha
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D016030:Kidney Transplantation; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016035:Pancreas Transplantation; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: EuroQol-5 Dimensions; Gastrointestinal Quality of Life Index; outcomes; pancreas transplantation; quality of life