Health-related quality of life in Egyptian patients after liver transplantation

Introduction-Aim. Health-Related Quality of Life (HRQOL) has become an important focus of patient care and clinical outcomes research with the improvement in patient and graft survival after liver transplanta-tion (LT). The current study was designed to evaluate the post-transplant HRQOL profiles using the Liver Disease Quality of Life 1.0 (LDQOL 1.0) Questionnaire and demonstrate the possible effect of peri-trans-plant clinical covariates on these profiles. Material and methods. Participants included pre-transplant group (waiting-list patients n = 50) and post-transplant group (mean 5 ± 4 years after deceased or living do-nor LT n = 103) who were recruited from 3 specialized centers in Egypt. We applied the LDQOL 1.0 ques-tionnaire; a 111-item containing the Short Form-36 version 2.0 (SF-36v2) as a generic component supplemented by 75 disease-specific items. The etiology of cirrhosis, co-morbidities, model for end-stage liver disease (MELD), Child-Pugh class and post-operative complications were analyzed. Results. All reci-pients had significant higher HRQOL scores than patients in waiting-list using both questionnaire compo-nents. Recipients with pre-LT MELD ≥ 15, Child-Pugh class C, history of hepatocellular carcinoma (HCC) demonstrated low HRQOL scores. Recipients without post-operative surgical complications had a statisti-cally better HRQOL using the disease-specific, but not the SF-36v2 component. On the other hand, both components demonstrated non-significant lower scores in recipients with rejection episodes, cytomegalo-virus (CMV) infection and hepatitis C recurrence had compared to those without medical complications. Conclusion. Generally HRQOL improves dramatically after LT as assessed by LDQOL questionnaire. Mo-reover, combined questionnaires can provide accurate information about the possible impaired HRQOL post-LT due to pre-transplant disease severity and post-operative complications.