QUALITY-OF-LIFE, MAJOR MEDICAL COMPLICATIONS AND HOSPITAL-SERVICE UTILIZATION IN PATIENTS WITH PRIMARY BILIARY-CIRRHOSIS AFTER LIVER-TRANSPLANTATION

Aims/Methods: Major medical complications, hospital service utilizatio n and quality of life were investigated in 26 out of 29 consecutive pr imary biliary cirrhosis transplanted patients who survived at least 2 years after the procedure (90% survival rate). Results: Before liver t ransplant, the most relevant clinical data were jaundice (96%), prurit us (92%), ascites (50%), gastrointestinal bleeding (19%), hepatic ence phalopathy (12%) and bone pain (12%), During the first postoperative y ear, the most significant complications were bone pain (58%) and fract ures (31%), arterial hypertension (50%), and mild/moderate renal failu re (46%), The frequency of these complications remained similar during the second year, but there was a significant reduction in the inciden ce of bone fractures, Bone pain was the only postoperative complicatio n which correlated with an increased number of unscheduled outpatient and emergency visits, Quality of life was measured cross-sectionally e ither at or after the second postoperative year, The Karnofsky index w as 90 in 69% of the patients and 76% were able to perform usual daily activities, Self-assessed health perception was good or very good in a lmost all the patients. However, the Nottingham Health Profile showed that approximately 70% of the patients gave a positive response to som e questions in areas of pain, sleep, emotional reactions and physical activities. Conclusions: The results of the present study confirm that patients with primary biliary cirrhosis have a high survival rate aft er liver transplantation and that bone pain and fractures are importan t postoperative complications, Good self-perceived health and return t o daily activities evidenced in most PBC patients should be balanced w ith problems identified by more specific tools, which could have an im pact in the health service utilization and quality of life.