QUALITY-OF-LIFE FOLLOWING TRANSPLANTATION OF THE HEART, LIVER, AND LUNGS

The purpose of this study was to describe the quality of life of patie nts who have received a transplant of the heart, liver, and lungs. We wished to document how the different patient groups fared in relation to each other with respect to physical, psychological, and social func tioning, as well as in relation to published normative data. We also w ished to identify factors that contribute to better functioning. We se nt out a questionnaire by mail and received responses from 55 heart, 1 49 liver, and 59 lung transplant recipients (82% response rate). Measu res included the SF-36, Mental Health inventory, the State Anxiety Inv entory, the UCLA Loneliness Scale-Revised, a quality of life measure t hat rated degree of improvement since transplantation, a measure of de gree of difficulty in following medical and lifestyle regimens, sleep disturbance, and the Illness Intrusiveness Rating Scale. Results indic ated that lung transplant patients reported better functioning than he art or liver transplant patients in all three domains of physical, psy chological, and social functioning. Lung patients' level of functionin g was equivalent to or better than published norms for the SF-36. Hear t and liver recipients reported equivalent functioning to published no rms in some domains, but reported impairment in the areas of physical and social functioning. Heart patients especially reported greater int rusiveness of their illness on their daily lives and indicated more di fficulty complying with their lifestyle regimen. In all three groups, a large majority of patients reported feeling that life had improved s ince transplant with respect to health, energy level, activity level, and overall quality of life. Fewer patients reported improvements in t he areas of sex life, marriage, family relationships, and social relat ionships. Where there were differences among the three patient groups, again it was the lung patients who reported more improvement in life since transplantation. Patients with better physical functioning tende d to have more energy and pep, to be younger, to see themselves as bei ng in better health, to feel less intrusion on their lives of their il lness, and to be employed. Those with better psychological functioning tended to report less sleep disturbance, less loneliness, better soci al functioning was associated with better mental health, less illness intrusiveness, and less role impairment as a result of physical or emo tional factors. Relatively few patients-roughly a quarter of the total sample-reported that they were working either full or part time. We c onclude that transplantation results in improved quality of life overa ll, but that problems persist for some patients in their physical and social functioning. Interventions aimed at improving rehabilitation in specific targeted areas may enable patients to resume a more fulfilli ng lifestyle posttransplant. (C) 1996 Elsevier Science Inc.