R Siriwardana, B Gunetilleke, S Jayatunge, A Weerasooriya, M Niriella, A Dassanayake, S Ranaweera, S Tillakaratne
{"title":"The long-term quality of life following liver transplantation in a developing country with a free health care system.","authors":"R Siriwardana, B Gunetilleke, S Jayatunge, A Weerasooriya, M Niriella, A Dassanayake, S Ranaweera, S Tillakaratne","doi":"10.4038/cmj.v67i3.9695","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Developing countries with limited resources are yet to establish universal liver transplant (LT) services to cater to their population free of charge. In this unique setting, no data are published on the long-term Quality of life (QOL) of LT survivors.</p><p><strong>Objectives: </strong>Compare the long-term quality of life of post-liver transplant patients with a matching cohort of pretransplant cirrhotic patients and a matching non cirrhotic control group. Methods: Of the 45 liver transplants that were performed there were 24 patients who completed over 6 months of follow-up. Of these, 4 patients died (including one lost to follow-up) after six months. The remaining 20 post-transplant patients were the subjects for QOL assessment. One post-transplant recipient was matched with two pre-transplant cirrhotic patients and non-cirrhotic healthy control group. QOL was evaluated by the SF-36 questionnaire.</p><p><strong>Results and conclusions: </strong>The median age was 54 years (27-67) and 85% (n=17) were male. The median follow up was 24 months (6- 94 months). The median MELD score was 17 (11-22) and 75% (n=15) were due to cryptogenic cirrhosis. Post-operatively three (15%) developed graft rejection, five (25%) had infections and ten (50%) suffered drug related complications. 95% (n= 19) of the population had satisfactory drug compliance. The study population had significantly better QOL compared to control in all eight domains (p<0.05) including physical functioning (76% vs 52.7%), physical health (80% vs 7.9%), emotional problems (93% vs 17.1%), energy (77% vs 47%), emotional wellbeing (80% vs 61.1%), social functioning (86.9% vs 56.9%), pain (82% vs 47.5%) and general health (67.5% vs 37.5%). The study population had similar quality of life compared to the healthy control group with better-perceived emotional well-being.</p><p><strong>Conclusion: </strong>Long-term survivors after LT have significantly improved QOL in a setting with limited resources.</p>","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ceylon Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4038/cmj.v67i3.9695","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Developing countries with limited resources are yet to establish universal liver transplant (LT) services to cater to their population free of charge. In this unique setting, no data are published on the long-term Quality of life (QOL) of LT survivors.
Objectives: Compare the long-term quality of life of post-liver transplant patients with a matching cohort of pretransplant cirrhotic patients and a matching non cirrhotic control group. Methods: Of the 45 liver transplants that were performed there were 24 patients who completed over 6 months of follow-up. Of these, 4 patients died (including one lost to follow-up) after six months. The remaining 20 post-transplant patients were the subjects for QOL assessment. One post-transplant recipient was matched with two pre-transplant cirrhotic patients and non-cirrhotic healthy control group. QOL was evaluated by the SF-36 questionnaire.
Results and conclusions: The median age was 54 years (27-67) and 85% (n=17) were male. The median follow up was 24 months (6- 94 months). The median MELD score was 17 (11-22) and 75% (n=15) were due to cryptogenic cirrhosis. Post-operatively three (15%) developed graft rejection, five (25%) had infections and ten (50%) suffered drug related complications. 95% (n= 19) of the population had satisfactory drug compliance. The study population had significantly better QOL compared to control in all eight domains (p<0.05) including physical functioning (76% vs 52.7%), physical health (80% vs 7.9%), emotional problems (93% vs 17.1%), energy (77% vs 47%), emotional wellbeing (80% vs 61.1%), social functioning (86.9% vs 56.9%), pain (82% vs 47.5%) and general health (67.5% vs 37.5%). The study population had similar quality of life compared to the healthy control group with better-perceived emotional well-being.
Conclusion: Long-term survivors after LT have significantly improved QOL in a setting with limited resources.
期刊介绍:
The Ceylon Medical Journal, is the oldest surviving medical journal in Australasia. It is the only medical journal in Sri Lanka that is listed in the Index Medicus. The CMJ started life way back in 1887 as the organ of the Ceylon Branch of the British Medical Association. Except for a brief period between 1893 and 1904 when it ceased publication, the CMJ or its forbear, the Journal of the Ceylon Branch of the British Medical Association, has been published without interruption up to now. The journal"s name changed to the CMJ in 1954.