Health-related quality of life after liver transplantation for adult recipients.

1. Pretransplantation health-related quality of life scores are affected by the etiology of liver cirrhosis, with hepatocellular and cholestatic etiologies having higher health-related quality of life scores than alcohol or viral hepatitis etiologies. 2. Posttransplantation health-related quality of life scores are not affected by the etiology of the original liver cirrhosis, but transplant recipient scores continue to remain significantly lower than those of healthy patient controls. 3. During the first 6 months after liver transplantation, the majority of physical and mental components of health-related quality of life scores improve, but these increases are not sustained in the long term. 4. At 1 year after liver transplantation, emotional and mental health-related quality of life scores begin to decrease. 5. During postoperative years 1 to 5, episodes of acute cellular rejection and patient age over 60 years decrease physical function and overall general health-related quality of life scores. 6. Beyond 5 years after orthotopic liver transplantation, age over 60, osteoporosis, and episodes of chronic rejection decrease health-related quality of life scores through decreases in the physical function and bodily pain domains. 7. Hepatitis C as an indication for liver transplantation is an independent factor in decreasing posttransplantation health-related quality of life scores. 8. Further studies are necessary that include a complete evaluation of the effects of gender, socioeconomic status, education, and ethnicity in order to better understand factors influencing post-liver transplantation health-related quality of life scores. 9. The development of a health-related quality of life assessment tool specific to transplantation could help us to more accurately assess factors (such as immunosuppression) that alter posttransplantation health-related quality of life.