QUALITY-OF-LIFE OF PATIENTS AFTER INTESTINAL TRANSPLANTATION

Background. Quality of life is an important consideration in evaluatin g new medical or surgical treatments. Intestinal transplantation is no w available for patients with irreversible intestinal failure, We comp ared quality of life among patients with intestinal failure receiving home parenteral nutrition (HPN) to that among patients who underwent i ntestinal transplantation (ITx) at the University of Pittsburgh Medica l Center. Methods. The results of the Quality of Life Inventory, a sel f-administered questionnaire, were compared among 10 ITx recipients an d 10 HPN patients. Change in quality of life was examined longitudinal ly over a 2-year period with repeat testing in four patients in each g roup. Results. ITx recipients were evaluated at mean time of 2.7 years after transplantation and after a mean period of 5.3 years of intesti nal failure. HPN patients were evaluated after a mean period of 5.1 ye ars of intestinal failure and were similar to the transplant recipient s in age, gender, race, social status, education, etiology, and durati on of disease. Assessed quality off life was markedly similar between HPN-dependent patients and ITx recipients, with significant difference s in only 2 of 25 domains, despite the difficult early postoperative c ourse and complex management that accompany intestinal transplantation . In longitudinal follow-up (n=4), ITx recipients reported significant improvement in anxiety (P=0.02), sleep (P=0.03), and impulsiveness/co ntrol (P<0.001), reflecting a progressive adjustment to their posttran splant status. Conclusion. The quality of life in ITx recipients is si milar to that in HPN-dependent patients. Quality of life among ITx rec ipients improves over time with decreased anxiety over physical functi oning, Further research and efforts to improve quality of life in tran splant recipients are needed.