Abstract
BackgroundHealth-related Quality of life (HRQoL) is a major goal of clinical management after liver transplantation (LTx). There is still disagreement on the effects of social-demographic factors and changes in the allocation system on HRQoL. The aim of this study was to evaluate the impact of social-demographic factors, mode of organ-allocation, waiting time and hepatocellular carcinoma (HCC) on HRQoL after LTx.MethodsHRQoL was assessed using the EORTC-QLQ-C30 questionnaire, which was sent to 238 recipients. Investigated parameters included age, sex, distance to transplant center, follow-up at hospital, size of hometown, highest education, marital status, having children, background liver disease, waiting time, mode of allocation, HCC, hospitalization after LTx and diagnosis of malignancy after LTx. All evaluated parameters were entered into multivariate linear regression analysis.ResultsCompleted questionnaire were returned by 73 % of the recipients. After LTx, the HRQoL-function scales increased over time. Age, marital status, highest education, completed professional training, working status, job position, duration of waiting time to LTx, distance to transplant center, place offollow, HU-statuts, mode of organ allocation and duration of hospitalization were associated with significantly worse function- and significantly lower symptom scales. HCC as a primary disease did not affect HRQoL.ConclusionsLow HRQoL correlated significantly with MELD-based organ allocation, more than 28-day hospitalization, divorced status, lower education- and non-working status, higher distance to transplant center, follow up at transplant center, HU-status, shorter waiting time to LTx and younger age. Improvement of HRQoL after LTx may require clinical management of pain, psychotherapy and financial support.
Highlights
Since the reporting of the first liver transplantation (LTx) in 1963 by Starzl et al [1], the estimated overall 1-year and 5-year survival rates exceed 85 and 70 % [2] and LTx has become the standard therapy for end-stage liver disease
Of the 252 patients, 14 patients had transferred and followed up at a different transplant center and their data were excluded from the analysis
The mean duration of hospitalization was longer for patients in the European Liver Allocation System (ELAS)-era (36 days), compared with that in the Model for End-Stage Liver Disease (MELD)-era (32 days)
Summary
Since the reporting of the first liver transplantation (LTx) in 1963 by Starzl et al [1], the estimated overall 1-year and 5-year survival rates exceed 85 and 70 % [2] and LTx has become the standard therapy for end-stage liver disease. Health-related quality of life (HRQoL) after LTx has gained more interest in the transplantation. Based on the increased proportion of patients with HCC on the LTx waiting list, we analyzed the impact of HCC, compared to non-tumor liver disease, on HRQoL. We analyzed the impact of the waiting time to LTx on the HRQoL. Health-related Quality of life (HRQoL) is a major goal of clinical management after liver transplantation (LTx). There is still disagreement on the effects of social-demographic factors and changes in the allocation system on HRQoL. The aim of this study was to evaluate the impact of social-demographic factors, mode of organ-allocation, waiting time and hepatocellular carcinoma (HCC) on HRQoL after LTx
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