Tome Santiago, Wells Jennifer T, Said Adnan, Lucey Michael R
Liver Unit, Internal Medicine Department, Complejo Hospitalario Universitario de Santiago, C/Choupana s/n, Santiago de Compostela 15705, Spain.
J Hepatol. 2008 Apr;48(4):567-77. doi: 10.1016/j.jhep.2007.12.013. Epub 2008 Jan 28.
BACKGROUND/AIMS: Although many studies have reported significant improvements in quality of life (QOL) after liver transplantation (LT), consistent data on areas of improvement are lacking. To perform a systematic review on medical literature of QOL after LT paying particular attention to studies that utilized the most commonly adopted study instrument, Short Form-36 (SF-36).
To collect studies focused on QOL in adult LT recipients, from 1963 to 2007, cited in Pub Med, Embase or Cochrane databases. From an initial identification of 613 articles, we selected 44 longitudinal studies with pre- and post-LT data that we assessed using a sign test, and 19 used SF-36, which we analyzed separately.
Longitudinal data showed remarkable improvement of common domains of QOL comparing pre- and post-transplant items. However, analysis of 16 SF-36 cross-sectional studies comparing post-LT patient domains with control population showed significantly higher ratings for controls in six while no differences were found in two.
This review suggests that whereas general QOL improves after LT, when compared with healthy controls, LT recipients have significant deficits in QOL. Consequently, the previously reported QOL benefits after LT may have been overstated.
背景/目的：尽管许多研究报告了肝移植（LT）后生活质量（QOL）有显著改善，但关于改善领域的一致数据却很缺乏。为了对肝移植后生活质量的医学文献进行系统评价，特别关注使用最常用研究工具即简明健康状况调查问卷（SF-36）的研究。
收集1963年至2007年发表在PubMed、Embase或Cochrane数据库中关于成年肝移植受者生活质量的研究。从最初识别出的613篇文章中，我们选择了44项有肝移植前后数据的纵向研究，并用符号检验进行评估，其中19项使用了SF-36，我们对其进行单独分析。
纵向数据显示，与移植前项目相比，生活质量的常见领域有显著改善。然而，对16项将肝移植后患者领域与对照人群进行比较的SF-36横断面研究分析显示，在六个领域中对照组的评分显著更高，而在两个领域中未发现差异。
本综述表明，虽然肝移植后总体生活质量有所改善，但与健康对照相比，肝移植受者在生活质量方面存在显著不足。因此，先前报道的肝移植后生活质量益处可能被夸大了。
