Impact of medical, health related, social and occupational factors on post-liver transplant recovery: a longitudinal study

Abstract

Purpose: Organ transplantation is a serious surgery with nearly 10% of patients failing to survive the first three months. Studies of quality of life reflect an increase post-transplant, as compared to pre-transplant, then reports vary including a trend towards decreasing QOL scores by the end of the first transplanted year. In this first year, patients have an increased risk of re-hospitalization due to infection, failure of the body to accept the graft, problems with anti-rejection medications or post- surgical complications. Methods: A longitudinal study of liver transplant recipients (n=23) followed medical, social, and occupational factors, along with SF-36 measures. Results: Variability in QOL scores at 1, 2, 3, 6, 9, and 12 months were directly related to identifiable factors. In those subjects where health returned in an uncomplicated manner, QOL scores consistently improved with the greatest change occurring over the first six months and then tapering off through the end of the first year. Conclusions: These subjects almost uniformly expressed frustration at the length of time it took to return to a healthy state. In circumstances where recovery was delayed due to medical reasons, QOL scores declined significantly until the problems were resolved. In several cases, QOL scores stayed low as these individuals were unprepared for the potential complications associated with this difficult surgery.