Abstract
181 HCV has emerged as a leading indication for liver transplantation; nearly 50% of the patients develop recurrent HCV hepatitis, usually within a year after transplantation. Despite significant morbidity associated with HCV recurrence, a decreased survival has not been demonstrated. However, the quality of life, psychosocial sequelae, and functional status of liver transplant recipients with HCV recurrence are not known. Quality of life, psychological stress (Profile of Mood States Scale), depression (Beck Depression Inventory), adaptive coping (Ways of Coping Scale) and functional status (Karnofsky Performance Scale) were prospectively assessed in 60 liver transplant recipients at baseline (pretransplant), 6 mo., and 12 mo. posttransplant; comparisons were made between patients with recurrent HCV hepatitis vs. all other patients. HCV hepatitis developed in 14 patients, a median of 317 days after transplantation. At 6 mo., the HCV patients had significantly lower functional status (p =.02) and had experienced less of a gain in physical functioning from baseline than other patients (p =.05). Quality of life, depression, and psychologic stress were not different at 6 mo. At 12 mo., the HCV patients had significantly lower quality of life (p=.01), greater depression (p =.03), higher psychological stress (p =.02), and lower physical functioning (p =.01) than other patients. By 12 mo., quality of life had declined by 6% and depression had increased by 19% as compared to baseline in patients with HCV, whereas quality of life had increased by 16% and depression had declined by 19% in all other patients. Outcome measures in liver transplant patients with HCV must include not only patient survival, but also quality of life sequelae; recurrent HCV hepatitis is associated with significantly impaired quality of life and functional status as compared to all other patients.
Published Version
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