Health-related quality of life of 256 recipients after liver transplantation

AIM： To investigate health-related quality of life （HRQoL） and psychological outcomes in 256 adults who had un- dergone liver transplantation （LT）. METHODS： A stratified random sampling method was used in this follow-up multicenter study to select a representative sample of recipients undergoing either living donor liver transplantation （LDLT） or deceased donor liver transplantation （DDLT）. HRQoL was mea- sured by using the Chinese version of Medical Out- come Study Short Form-36 （SF-36）, and psychological outcomes by using the beck anxiety inventory （BAI） and the self-rating depression scale （SDS）. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via ques- tionnaires.RESULTS： A total of 256 patients were sampled, in- cluding 66 （25.8%） receiving LDLT and 190 （74.2%） undergoing DDLT; 15 （5.9%） recipients had anxiety and four （1.6%） developed severe depression after the operation. Compared with LDLT recipients, DDLT patients had higher scores in general health （60.33 ± 16.97 vs 66.86 ± 18.42, P = 0.012）, role-physical （63.64 ± 42.55 vs 74.47 ± 36.46, P = 0.048）, role- emotional （61.11 ± 44.37 vs 78.95 ± 34.31, P = 0.001）, social functioning （78.60 ± 22.76 vs 88.16 ± 21.85, P = 0.003）, vitality （70.30 ± 15.76 vs 75.95 ± 16.40, P = 0.016）, mental health （65.88 ± 12.94 vs 71.85 ± 15.45, P = 0.005）, physical component summary scale （PCS, 60.07 ± 7.36 vs 62.58 ± 6.88, P = 0.013） and mental component summary scale （MCS, 52.65 ± 7.66 vs 55.95 ± 10.14, P = 0.016）. Recipients 〉 45 years old at the time of transplant scored higher in vitality （77.33 ± 15.64 vs 72.52 ＋ 16.66, P = 0.020）, mental health （73.64 ± 15.06 vs 68.00 ± 14.65, P = 0.003） and MCS （56.61 ± 10.00 vs 54.05 ± 9.30, P = 0.037） than those aged ≤ 45 years. MCS was poorer in re- cipients with than in those without complications （52.92 ± 12.21 vs 56.06 ± 8.16, P = 0.017）. Regarding MCS （55.10 ± 9.66 vs 50.0 ± 10.0, P 〈 0.05） and PCS （61.93 ± 7.08 vs 50.0 ± 10.0, P 〈 0.05）, recipients scored better than the Sichuan general and had improved overall QoL compared to patients with chronic diseas- es. MCS and PCS significantly correlated with scores of the BAI （P 〈 0.001） and the SDS （P 〈 0.001）. CONCLUSION： Age 〉 45 years at time of transplant, DDLT, full-time working, no complications, anxiety and depression were possible factors influencing postop- erative HRQoL in liver recipients.