Quality of life after liver transplantation. A systematic review

[Guest guest]

doi:10.1016/j.jhep.2007.12.013 Copyright © 2008 European Association for the Study of the Liver Published by Elsevier Ireland Ltd.

Quality of life after liver transplantation. A systematic review

Santiago Tome1, , , T. Wells2, Adnan Said2 and R. Lucey2 1Liver Unit, Internal Medicine Department, Complejo Hospitalario Universitario de Santiago, C/Choupana s/n, Santiago de Compostela 15705, Spain2Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Received 24 October 2007; accepted 19 December 2007. Associate Editor: P.-A. Clavien. Available online 28 January 2008.

Background/Aims

Although many studies have reported significant improvements in quality of life (QOL) after liver transplantation (LT), consistent data on areas of improvement are lacking. To perform a systematic review on medical literature of QOL after LT paying particular attention to studies that utilized the most commonly adopted study instrument, Short Form-36 (SF-36). Methods

To collect studies focused on QOL in adult LT recipients, from 1963 to 2007, cited in Pub Med, Embase or Cochrane databases. From an initial identification of 613 articles, we selected 44 longitudinal studies with pre- and post-LT data that we assessed using a sign test, and 19 used SF-36, which we analyzed separately. Results

Longitudinal data showed remarkable improvement of common domains of QOL comparing pre- and post-transplant items. However, analysis of 16 SF-36 cross-sectional studies comparing post-LT patient domains with control population showed significantly higher ratings for controls in six while no differences were found in two. Conclusions

This review suggests that whereas general QOL improves after LT, when compared with healthy controls, LT recipients have significant deficits in QOL. Consequently, the previously reported QOL benefits after LT may have been overstated.

Keywords: Quality of life; Liver transplantation; SF-36

The authors declare that they do not have anything to disclose regarding funding from industries or conflict of interest with respect to this manuscript.Corresponding author.

Journal of Hepatology Volume 48, Issue 4, April 2008, Pages 567-577