Effect of Orthotopic Liver Transplantation on the Health-Related Quality of Life in Indian Patients with End-Stage Liver Disease: A Prospective Study
Author(s): Vinayak Nikam, Vasudevan Ramaswamy, Abhideep Chaudhary, Suresh Singhvi.
Background: End-stage liver disease severely affects all the aspects of a patient’s life including mental and physical health. Orthotopic liver transplantation (OLT) provides a definitive therapeutic measure for patients with end-stage liver disease. Improvements in patient survival have led to a shift in focus from acute management to long-term outcomes after liver transplantation. Health-related quality of life (HRQoL) is an important aspect of long-term outcomes as it incorporates the physical, social, and emotional well being of the patient. We report our experience regarding the HRQoL pre and post-liver transplant using Standard SF 36 questionnaire in living donor liver transplant (LDLT) recipients from India.
Methods: The study was designed as a single-center, observational, prospective study. We assessed the HRQoL using the SF 36 health questionnaire before transplant and three months post-liver transplant in sixty liver recipients from June 2013 to March 2015. Statistical analysis was performed using SPSS statistical software, version 17.0. Continuous and categorical variables were analyzed using paired t-test and non-parametric sign tests respectively. Pearson correlation test was used to analyze the relationships between HRQoL and pre-transplantation severity of the liver disease.
Results: Sixty patients underwent LDLT with 83.3% of them being male with a median age of 44.7 years. We found significant improvement in all the eight dimensions of SF 36 health score in recipients at 3 months post-liver transplant (p<0.001) compared to pre-transplant. Post-transplant HRQoL in domains of vitality, physical functioning, and mental component summary scores significantly correlated with liver disease severity, which measured by Model for End-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) score (p<0.05).
Conclusions: Liver transplant recipients have improved HRQoL when compared to their pre-transplant status. The severity of the Liver disease assessed with MELD and CPT scores has a minor effect on HRQoL after OLT.