Abstract
Resumo Objetivo Analisar a influência da gravidade da doença hepática na qualidade de vida dos pacientes antes e depois do transplante de fígado. Métodos Estudo descritivo com 150 receptores de transplante hepático, maiores de 18 anos. A gravidade foi avaliada pelo Child e MELD e aplicado o Liver Disease Quality of Life. Foi utilizado teste t ou Mann-Whitney para comparação das médias dos domínios e ANOVA ou Kruskal-Wallis para comparação entre grupos. Resultados Antes do transplante, os pacientes com Child C obtiveram menores escores de qualidade de vida do que os com Child A. Pacientes com MELD menor ou igual a 15 tiveram aumento significativo das médias em 10 domínios, enquanto os pacientes com MELD superior a 15 tiveram aumento nos 12 domínios. Conclusão Houve influência negativa da gravidade pelo CTP na qualidade de vida antes do transplante. O MELD não interferiu significativamente nos resultados pós-transplante, mesmo com elevação das médias.
Highlights
End-stage liver failure is a pathological condition that has great impact on people’s lives, with liver transplant providing the only possibility for reversing the terminal situation, which impacts the biological, psychological and social levels.[1]In 2013, Brazil ranked second in absolute numbers for liver transplantation among 30 surveyed countries, second only to the United States
Liver Disease Quality of Life (LDQOL) Domains Symptoms related to liver disease Effects of liver disease Concentration Memory Quality of social interaction Health distress Sleep Loneliness Hopelessness Stigma of liver disease Sexual function* Sexual problems*
The order of primary disease etiology prevalence differed from the data released by the Organ Procurement and Transplantation Network, including a total 5,805 liver transplants in adults in the United States, in which Hepatitis C was first with 23.5%, followed by alcoholic cirrhosis, with 17.6%.(10)
Summary
End-stage liver failure is a pathological condition that has great impact on people’s lives, with liver transplant providing the only possibility for reversing the terminal situation, which impacts the biological, psychological and social levels.[1]In 2013, Brazil ranked second in absolute numbers for liver transplantation among 30 surveyed countries, second only to the United States. General indicators of the severity of liver failure are used in the assessment of candidates for transplantation: Child-Turcotte-Pugh (CTP) and the Model for End-stage Liver Disease (MELD). These indicators are used to establish liver transplantation priority, disease prognosis, prediction of survival and mortality after transplantation, in addition to serving as a parameter for assessing health-related quality of life (HRQOL).(3). Results are scored on a scale ranging from 5 to 15 points; they are stratified into class A [5,6], B [7,8,9] or C [10,11,12,13,14,15], where greater values indicate greater disease severity , providing predictive values of one-to-two year patient survival.[3]. The score is based on a formula whose variables are: serum creatinine (Cr), total bilirubin (BT), prothrombin time (PT) and international normalized ratio (INR), ranging from 6 to 40 points; it
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