Life satisfaction in renal transplant recipients: Preliminary results fromthe Transplant Learning Center

The Transplant Learning Center (TLC) was designed to improve quality of lif e (QOL) and preserve graft function in solid-organ transplant recipients. T o meet the specific goals of the program, the Life Satisfaction Index and T ransplant Care Index were designed to serve as composite measures for measu ring transplant-specific QOL and the ability to care for a transplant, resp ectively. In this study, we analyzed self-reported health information to ex amine relationships between comorbidities and individual posttransplantatio n side effects, life satisfaction, and transplant care, defined by renal tr ansplant recipients. Patients entered the TLC through self-referral or refe rral by a health professional. Included in the analysis were 3,676 TLC enro llees with a mean time since transplantation of 4.8 years. Comorbidities an d adverse effects were common, with high blood pressure reported by 89% of respondents and unusual hair growth reported by 70%. Sexual dysfunction and headache had a greater Impact on QOL than more common adverse effects, suc h as changes in body and facial shape, hirsutism, and tremor. Regression mo deling was used to identify the most significant associations between QOL i ndices and structural (nonmedical), medical, and psychosocial factors. Grea ter life satisfaction was most strongly associated with being in control of one's health and living a normally active life with satisfying emotional r elationships. Management of such clinical problems as adverse effects of me dication and nonadherence should be informed by the patient's perspective. Clinicians should actively solicit information about physical activity, app earance concerns, side effects of medications, nonadherence, and sexual and relationship issues when evaluating renal transplant recipients. (C) 2001 by the National Kidney Foundation, Inc.