Sainz-Barriga M, Baccarani U, Scudeller L, Risaliti A, Toniutto P L, Costa M G, Ballestrieri M, Adani G L, Lorenzin D, Bresadola V, Ramacciatto G, Bresadola F
Department of Surgery and Transplantation Unit, University of Udine, Udine, Italy.
Transplant Proc. 2005 Jul-Aug;37(6):2601-4. doi: 10.1016/j.transproceed.2005.06.045.
Quality-of-life (QoL) assessment includes health status, disability, psychological wellness, and social performance. We sought to evaluate the effect of liver transplantation (OLT) on the QoL of patients awaiting the procedure and its variations up to 8 years afterwards.
LEIPAD-perceived QoL and BSI-psychological distress tests were used. Patients were divided in four groups (waiting list patients, 1 to 2 years after LT, 3 to 4 years after LT, 5 to 8 years after LT). Patients were also evaluated for type and severity of liver disease.
We evaluated 126 patients, 71% male, 29% female, median age 60.7 years (range 40 to 76 years), median follow-up 4 years (range 1 to 8). The patients on the waiting list scored worse both in global stress index (GSI) and total LEIPAD scores than transplanted patients. Upon univariate linear regression analysis, the only dimension associated with time groups was LEIPAD--physical functioning, showing a progressive improvement of perceived physical status with time from transplant. Severity of liver disease showed a protective effect, probably reflecting a better control of stressful events from patients transplanted at advanced stages of liver disease. Protective effects were found for male sex, retired, cohabitant patients, and the degree of education. Housewife and widow patients showed negative associations with BSI and LEIPAD dimensions. No independent predictors of QoL were found in this study.
OLT improves most, but not all, QoL and psychological distress domains.
生活质量（QoL）评估包括健康状况、残疾情况、心理健康和社会表现。我们试图评估肝移植（OLT）对等待该手术患者生活质量的影响及其术后长达8年的变化情况。
使用LEIPAD感知生活质量和BSI心理困扰测试。患者分为四组（等待名单患者、肝移植后1至2年、肝移植后3至4年、肝移植后5至8年）。还对患者的肝病类型和严重程度进行了评估。
我们评估了126例患者，其中男性占71%，女性占29%，中位年龄60.7岁（范围40至76岁），中位随访时间4年（范围1至8年）。等待名单上的患者在总体压力指数（GSI）和LEIPAD总分上的得分均低于移植患者。单因素线性回归分析显示，与时间组相关的唯一维度是LEIPAD——身体功能，表明从移植后随着时间推移，感知到的身体状况逐渐改善。肝病严重程度显示出保护作用，这可能反映出对肝病晚期移植患者应激事件的更好控制。男性、退休人员、同居患者和教育程度显示出保护作用。家庭主妇和寡妇患者与BSI和LEIPAD维度呈负相关。本研究未发现生活质量的独立预测因素。
肝移植改善了大部分但并非全部生活质量和心理困扰领域。
