Karam Vincent H, Gasquet Isabelle, Delvart Valérie, Hiesse Christian, Dorent Richard, Danet Colette, Samuel Didier, Charpentier Bernard, Gandjbakhch Iradj, Bismuth Henri, Castaing Denis
Centre Hépato Biliaire, Hôpital Paul Brousse, 4 Avenue Paul Vaillant-Couturier, 94804 Villejuif Cedex, France.
Transplantation. 2003 Dec 27;76(12):1699-704. doi: 10.1097/01.TP.0000092955.28529.1E.
The yearly increasing survival rates testify to the success of transplantation, but questions remain relating to the quality of life (QOL) associated with long-term survival.
A sample of 126 liver recipients (Liver-R), 229 kidney recipients (Kidney-R), and 113 heart recipients (Heart-R) with more than 10 years posttransplant follow-up were included in the study with a response rate of 86%. Respondents were matched with healthy subjects recruited from general population (GP). The three groups of recipients and GP subjects completed a French version of the questionnaire used by the National Institute of Diabetes and Digestive and Kidney Disease, Pittsburgh, PA, and were compared for each score, with adjustments for age and sex.
Personal function and measures of disease by the transplant recipients were significantly worse than in the GP (P<0.0001), with the worst score in Kidney-R. No difference, either between organs or between organs and GP, was found regarding the perceived social and role function. However, for psychologic status and general health perception, Kidney-R had the least favorable performance when compared with GP (P<0.01) and also when compared with Liver-R (P<0.05). With the exception of Kidney-R, the well-being index of Liver-R and Heart-R was significantly better than the GP (P<0.001 and P<0.05, respectively).
The QOL beyond 10 years after liver, heart, and kidney transplantation is quite similar to the GP, with Kidney-R starting out as the worst, Heart-R as intermediate, and Liver-R the best.
逐年上升的生存率证明了移植手术的成功,但与长期生存相关的生活质量(QOL)仍存在问题。
本研究纳入了126例肝移植受者(Liver-R)、229例肾移植受者(Kidney-R)和113例心脏移植受者(Heart-R),这些受者均有超过10年的移植后随访记录,应答率为86%。研究对象与从普通人群(GP)中招募的健康受试者进行匹配。三组受者和GP受试者完成了宾夕法尼亚州匹兹堡市国立糖尿病、消化和肾脏疾病研究所使用的法语版问卷,并对每个得分进行比较,同时对年龄和性别进行了调整。
移植受者的个人功能和疾病指标明显比GP组差(P<0.0001),其中Kidney-R得分最差。在感知到的社会和角色功能方面,各器官之间以及器官与GP组之间均未发现差异。然而,在心理状态和总体健康感知方面,与GP组相比,Kidney-R表现最差(P<0.01),与Liver-R组相比也最差(P<0.05)。除Kidney-R外,Liver-R和Heart-R的幸福感指数明显高于GP组(分别为P<0.001和P<0.05)。
肝、心、肾移植术后10年以上的生活质量与普通人群相当,Kidney-R组最初最差,Heart-R组居中,Liver-R组最佳。