LONG-TERM QUALITY-OF-LIFE AFTER KIDNEY AND SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION

We are using a validated questionnaire (SF-36) to annually assess heal th-related quality of life (QOL) in kidney and pancreas-kidney transpl ant recipients. The SF-36 consists of eight scales to assess physical functioning, general health, and mental functioning. Norms and 95% con fidence intervals (C.I.) have been developed for the US population. At present, 1138 recipients with functioning grafts (520 Type I diabetic ; 618 nondiabetic) 1-10 yr post-transplant have completed the question naire. Of the recipients, 446 completed the questionnaire once; 632 tw ice; and 53 three times (305 after 1 yr; 266 after 2 yr; 256 after 3 y r; 206 after 4 yr; 192 after 5 yr; 150 after 6 yr; 130 after 7 yr; 138 after 8 yr; 125 after 9 yr; 92 after 10 yr). For both diabetic and no ndiabetic recipients, there was little change in average scores for ea ch scale between years (p = NS). In relation to the US population, ave rage scores for nondiabetics were below the 50th percentile on all 8 s cales; for diabetics < 25th percentile on the physical functioning and vitality scales, < 50th percentile on all others. For both diabetic a nd nondiabetic recipients, average scores were higher than reported no rms for patients with CHF, COPD, or depression but were similar to tho se with Htn or recent MI. Individual scores were then compared with ag e-matched means (+/-2 SEMs) (95% C.I.) for the US population. At each year post-transplant, up to 40% of nondiabetic and up to 65% of diabet ic recipients had scores below the 95% C.I. on individual scales (part icularly the physical functioning and general health scales) - e.g. ov er 30% nondiabetic and up to 60% diabetic recipients had scores on the physical functioning scales below the 95% C.I. More diabetic recipien ts (vs. nondiabetics) reported poor QOL on the physical functioning, g eneral health and social functioning scales. There was little differen ce in the mental health scales. For those with Type I diabetes, a simi lar percentage of kidney and K/P recipients reported QOL below the 95% C.I. for the age-matched population, except on the GH scale (better Q OL for K/P recipients). We conclude that successful transplant recipie nts report health-related QOL below that of the age-matched general po pulation but similar to those with other chronic diseases. Diabetic an d nondiabetic recipients have similar scores on the mental health scal es; nondiabetic recipients score better on the general health and phys ical functioning scales.