Department of Surgery and Vanderbilt Transplant Center, Vanderbilt University Medical Center, Nashville, Tennessee 37232-4753, USA.
HPB (Oxford). 2008;10(1):30-7. doi: 10.1080/13651820701883106.
To test the effects of pre- and post-transplant clinical covariates on post-transplant health-related quality of life (HRQOL) score profiles in liver transplant recipients.
HRQOL was measured before and after transplantation using the SF-36 Health Survey. Clinical data [diagnosis, model of end-stage liver disease (MELD) score, post-transplant rejection and infection episodes], pre-transplant functional performance (FP), and demographics were collected. Multivariate models for the eight SF-36 scales and two summary components were developed using multiple regression. Discriminant analysis was used to test whether the score profiles differentiated among recipients with and without hepatitis C virus (HCV) infection.
104 adults reported pre- and post-transplant HRQOL. Time post-transplant averaged 9+/-8 months (range 1-39). Scores on all SF-36 measures improved from pre- to post-transplant (p<0.001), and 7 of 10 models were significant (p<0.05). After controlling for pre-transplant HRQOL and time post-transplant, HCV infection had a negative effect on the role physical, bodily pain, and role emotional scales. History of a rejection episode had a negative effect on the bodily pain and vitality scales. MELD scores > or = 18 had a positive effect on the role physical scale. Pre-transplant FP and post-transplant infection episodes did not affect post-transplant HRQOL. HCV infection had a significant effect on the SF-36 score profile (canonical correlation=0.50; p<0.001).
Pre-transplant HCV infection, MELD score, and post-transplant rejection episodes have significant independent effects on HRQOL after liver transplantation. Their specific effects vary among the individual SF-36 scales, and HRQOL score profiles differ among HCV+ and HCV- recipients.
检测肝移植受者移植前后临床相关变量对移植后健康相关生活质量（HRQOL）评分的影响。
采用 SF-36 健康调查量表于移植前后分别测量 HRQOL。收集临床数据[诊断、终末期肝病模型（MELD）评分、移植后排斥和感染发作]、移植前功能表现（FP）和人口统计学数据。采用多元回归建立 8 个 SF-36 量表和 2 个综合成分的多个回归模型。判别分析用于检测评分模式是否能区分丙型肝炎病毒（HCV）感染受者和非感染受者。
104 例成人报告了移植前后的 HRQOL。移植后时间平均为 9±8 个月（范围 1-39）。所有 SF-36 指标评分均从移植前到移植后提高（p<0.001），10 个模型中有 7 个有统计学意义（p<0.05）。在控制移植前 HRQOL 和移植后时间后，HCV 感染对生理职能、躯体疼痛和情绪职能量表有负面影响。排斥发作史对躯体疼痛和活力量表有负面影响。MELD 评分>或=18 对生理职能量表有积极影响。移植前 FP 和移植后感染发作对移植后 HRQOL 无影响。HCV 感染对 SF-36 评分模式有显著影响（典型相关系数=0.50；p<0.001）。
移植前 HCV 感染、MELD 评分和移植后排斥发作对肝移植后 HRQOL 有显著独立影响。它们对个别 SF-36 量表的具体影响不同，且 HCV+和 HCV-受者的 HRQOL 评分模式不同。
