Quality of life before and after liver transplantation for cholestatic liver disease

Liver transplantation (LT) is an established therapy for patients with end- stage primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PS C), In this report, we describe the health status and quality of life (QOL) in patients with these cholestatic liver diseases before and after LT, A Q OL questionnaire was completed by 157 adult patients with PBC or PSC before and 1 year after liver transplantation at the Mayo Clinic or Baylor Univer sity Medical Center. This questionnaire measured four aspects of QOL, inclu ding symptoms; physical, social, and emotional functioning; health percepti ons; and overall QOL, Changes in these QOL parameters before and after LT w ere described, and regression analysis was used to assess the relationships between clinical and QOL factors. There were no differences in QOL paramet ers between patients with PBC and PSC. QOL following transplantation was su bstantially better than before transplantation. This was observed in all fo ur aspects of QOL, The degree of improvement as measured by effect size (di fference in mean scores divided by the pretransplantation standard deviatio n) was 0.53 for symptoms (P <.01), 1.16 for function (P <.01), 2.37 for hea lth satisfaction (P <.01), and 1.16 for overall QOL (P <.01). Patients' ove rall QOL before transplantation was significantly related to subjective and objective health status indicators and clinical factors such as ascites an d renal dysfunction. QOL at 1-year follow-up, however, could not be adequat ely predicted by the pretransplantation subjective health status and clinic al factors. Patients with end-stage cholestatic disease undergoing LT exper ience substantial improvement in all aspects of QOL addressed in this study . The patients' QOL 1 year after LT could not be predicted by pretransplant ation variables used in this study.