A longitudinal analysis of the impact of fatigue on return to activities of daily living during the first year after liver transplantation

Abstract

Liver transplantation is often thought of as organ recovery and lifesaving surgery. The reality is a prolonged and stressful time for the patient and their family (Scott & Brown, 2011). The persistence of fatigue after liver transplantation is well documented in the research literature (Aadahl, Hansen, Kirkegaard, & Groenvold, 2002; van den Berg-Emons et al., 2006; Van Ginneken et al., 2010). However, there is no evidence as to the timing of how this fatigue dissipates during the early transplanted period and its impact on quality of life. Furthermore, studies on changes in fatigue do not start until 6 months after transplant, leaving a gap in knowledge of the patient’s experience post-surgery up to this point. This ongoing longitudinal study is aimed at better understanding the recovery process. Patients from a Midwest medical center (N=21) were followed post-discharge, at weeks 1-8 and at months 3, 6, 9, and 12. The FACIT-Fatigue Scale (Cella, 1997) indicates a decrease in fatigue scores (less fatigue) in those subjects without adverse events. Adverse events including re-hospitalization, surgical complications and organ rejection were associated with higher FACIT scores (higher level of fatigue) and less resolution over this first year. Through this research Dr. Scott and her team hope to translate their findings into educational resources for patients and their families to understand what to anticipate during the post-transplant recovery period.