Author:
Bleisch Barbara,Schuurmans Macé M.,Klaghofer Richard,Benden Christian,Seiler Annina,Jenewein Josef
Abstract
BACKGROUND
Lung transplantation (LTx) provides a viable option for the survival of end-stage lung diseases. Besides survival as a clinical outcome measure, health-related quality of life (HRQoL) and psychological distress have become important outcomes in studies investigating the effectiveness of LTx in the short- and long-term.
OBJECTIVE
To assess and compare HRQoL trajectories of patients after LTx prior to and over a follow-up period of three years post-transplant, and to identify differences regarding distress, HRQoL and patient-related outcomes.
METHODS
In this longitudinal study, 27 lung transplant recipients were prospectively examined for psychological distress (Symptom Checklist short version-9; SCL-K-9), health-related quality of life (EuroQOL five dimensions questionnaire; EQ-5D), depression (HADS-Depression scale), and socio-demographic and medical outcomes at two weeks, three months, six months and three years following LTx. Additionally, potential outcome-related predictors for LTx-outcomes at three years post-transplant were assessed. Data were collected in accordance with guidelines set by the STROBE (strengthening the reporting of observational studies in epidemiology) statement.
RESULTS
Lung transplant recipients showed the most pronounced improvements in HRQoL and reduction in psychological distress between two weeks and three months post-transplant, with relative stable HRQoL and distress trajectories thereafter. The most important predictors of poor somatic health trajectories over time were the pre-transplant disease severity score and the pre-transplant HADS-Depression score. In addition, idiopathic pulmonary fibrosis (IPF) and pre-transplant extracorporeal membrane oxygenation (ECMO)-use predicted poorer survival, while cystic fibrosis was associated with better survival three years post-transplant.
COMCLUSION
Lung transplantation yields significant survival and HRQoL benefits, with its peak improvement at three months post-transplant. The majority of patients can preserve these health changes in the long-term. Patients with a worse HRQoL and higher psychological distress at six months post-transplant tended to have a poorer survival post-transplant. Other risk factors for poorer survival included IPF, pre-transplant ECMO-use, pre-transplant symptoms of depression, high pre-transplant disease severity and worse somatic disease severity trajectories. The majority of LTx-recipients were unable to work due to illness-related reasons.
Publisher
SMW Supporting Association
Reference34 articles.
1. Singer LG, Chowdhury NA, Faughnan ME, Granton J, Keshavjee S, Marras TK, et al. Effects of Recipient Age and Diagnosis on Health-related Quality-of-Life Benefit of Lung Transplantation. Am J Respir Crit Care Med. 2015;192(8):965–73.https://doi.org/10.1164/rccm.201501-0126OC
2. Seiler A, Klaghofer R, Ture M, Komossa K, Martin-Soelch C, Jenewein J. A systematic review of health-related quality of life and psychological outcomes after lung transplantation. J Heart Lung Transplant. 2016;35(2):195–202.
3. Thabut G, Mal H. Outcomes after lung transplantation. J Thorac Dis. 2017;9(8):2684–91.https://doi.org/10.21037/jtd.2017.07.85
4. Inci I, Schuurmans MM, Boehler A, Weder W. Zurich University Hospital lung transplantation programme: update 2012. Swiss Med Wkly. 2013;143:w13836.https://doi.org/10.4414/smw.2013.13836
5. Swiss Transplant Cohort Study (STCS). Swiss Transplant Cohort Study Report, May 2008 - December 2016. p. 27. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=2ahUKEwjyiqup8rjeAhUszoUKHdTIDL4QFjAAegQICRAC&url=http%3A%2F%2Fwww.stcs.ch%2Finternal%2Freports%2Fstcs_annual_report_june_2017.pdf&usg=AOvVaw0w4aFfWAt_xiPP0Fjw5nbx.
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献