title: Impact of different immunosuppressive regimens on the health-related quality of life following orthotopic liver transplantation.
abstract: BACKGROUND
  The influence of immunosuppression on the recipients' quality of life (QoL) is of major importance after OLT and has not yet been evaluated.
  
  
  METHODS
  The impact of different immunosuppression regimens after OLT was evaluated in 275 patients using the Short Form 36 (SF-36) survey. The following immunosuppressive strategies were compared: (a) CNI, (b) mTOR inhibitors, and (c) mTOR combined with CNI. All regimens were prescribed alone (mono) or in combination (+) with prednisolone and/or mycophenolate mofetil (MMF).
  
  
  RESULTS
  Highest scores were evident in patients in the mTOR+ group. There were significantly higher values for general health perceptions (GH, p = 0.049), vitality (VIT, p = 0.020), and physical component summary (PCS, p = 0.041) when compared to CNImono and for GH (p = 0.042) and VIT (p = 0.043), when compared to mTORmono. Early conversion to mTOR inhibitors (<two months after OLT) was associated with higher values for 7 of 10 scales, when compared to a late conversion (>two months after OLT), with a statistically significant improvement for the dimension role-emotional (RE, p = 0.027).
  
  
  CONCLUSIONS
  mTOR inhibitor-based regimens appear to have beneficial effects on QoL after OLT, especially after an early conversion.
authors.affiliation: Department of Visceral, Thoracic, Transplant and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Benzing
authors.affiliation: Department of Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Nicco
authors.initials: N
authors.lastname: Krezdorn
authors.affiliation: Department of Visceral, Thoracic, Transplant and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Förster
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hinz
authors.affiliation: Department of Visceral, Thoracic, Transplant and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Georgi
authors.initials: G
authors.lastname: Atanasov
authors.affiliation: Department of Visceral, Thoracic, Transplant and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Wiltberger
authors.affiliation: Department of Visceral, Thoracic, Transplant and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Mehmet H
authors.initials: MH
authors.lastname: Morgül
authors.affiliation: Department of Visceral, Thoracic, Transplant and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Undine G
authors.initials: UG
authors.lastname: Lange
authors.affiliation: Department of General, Visceral and Transplant Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Schmelzle
authors.affiliation: Department of Visceral, Thoracic, Transplant and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Hans-Michael
authors.initials: HM
authors.lastname: Hau
authors.affiliation: Department of Visceral, Thoracic, Transplant and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Bartels
mesh_terms: D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents
keywords: Quality of Life; SF-36; early conversion; immunosuppression; liver transplantation