Liver transplantation restores quality of life
A study in this month's Annals of Surgery investigates long-term patient outcome and quality of life after liver transplantation.
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20-year patient survival was 52%.
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Dr John Duffy and colleagues evaluated patient survival and allograft function and health-related quality of life (HRQOL) 20 years after orthotopic liver transplantation.
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Although liver transplantation is the established treatment of choice for acute and chronic liver failure, allograft function and recipient health-related quality of life -HRQOL 20 years after liver transplantation remain undefined.
Although liver transplantation is the established treatment of choice for acute and chronic liver failure, allograft function and recipient health-related quality of life -HRQOL 20 years after liver transplantation remain undefined.
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The researchers performed a prospective, cross-sectional study of liver transplantation recipients surviving 20 years or more.
The researchers performed a prospective, cross-sectional study of liver transplantation recipients surviving 20 years or more.
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The research team reviewed clinical data to identify factors associated with 20-year survival.
20-year patient survival was 52%
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The research team reviewed clinical data to identify factors associated with 20-year survival.
20-year patient survival was 52%
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Annals of Surgery
Survivors were directly contacted and offered a survey to assess
Survivors were directly contacted and offered a survey to assess
health-related quality of life-HRQOL, social support, and cognition.
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Logistic regression analysis was performed to identify clinical factors influencing health-related quality of life-HRQOL 20 years after liver transplantation.
Logistic regression analysis was performed to identify clinical factors influencing health-related quality of life-HRQOL 20 years after liver transplantation.
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The team noted that between 1984 and 1988, a total of 293 patients received 348 liver transplantations.
The team noted that between 1984 and 1988, a total of 293 patients received 348 liver transplantations.
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Of the 293 patients, 56% survived for 20 years or more.
Of the 293 patients, 56% survived for 20 years or more.
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The team found that actuarial 20-year patient survival was 52%, and 42% for graft survival.
Factors associated with 20-year survival included recipient age less than 18, nonurgent liver transplantation, no retransplantation, female gender, absence of biliary complications, and short total ischemia time.
The team found that actuarial 20-year patient survival was 52%, and 42% for graft survival.
Factors associated with 20-year survival included recipient age less than 18, nonurgent liver transplantation, no retransplantation, female gender, absence of biliary complications, and short total ischemia time.
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Rejection episodes were seen in a greater proportion of 20-year survivors than in nonsurvivors. Of the 168 survivors, 87 were contacted, and 68 completed the health-related quality of life-HRQOL surveys.
Rejection episodes were seen in a greater proportion of 20-year survivors than in nonsurvivors. Of the 168 survivors, 87 were contacted, and 68 completed the health-related quality of life-HRQOL surveys.
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The research team found that, compared with the general population, survivors had lower physical scores but comparable mental scores on the Short-Form-36.
The research team found that, compared with the general population, survivors had lower physical scores but comparable mental scores on the Short-Form-36.
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Overall health-related quality of life- HRQOL was significantly better in 20-year survivors than in patients with chronic liver disease, congestive heart failure, or diabetes.
Overall health-related quality of life- HRQOL was significantly better in 20-year survivors than in patients with chronic liver disease, congestive heart failure, or diabetes.
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Clinical factors associated with improved post-liver transplantation health-related quality of life-HRQOL were younger age at liver transplantation, allograft longevity, and strong social support.
Clinical factors associated with improved post-liver transplantation health-related quality of life-HRQOL were younger age at liver transplantation, allograft longevity, and strong social support.
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More than 90% of pediatric survivors completed high school.
After liver transplantation, 34% of pediatric recipients married, and 79% remained married at 20 years' follow-up.
More than 90% of pediatric survivors completed high school.
After liver transplantation, 34% of pediatric recipients married, and 79% remained married at 20 years' follow-up.
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Dr Duffy's team concludes, "More than 50% of liver transplantation recipients survive 20 years, achieve important socioeconomic milestones, and report quality of life superior to patients with liver disease or other chronic conditions."
Dr Duffy's team concludes, "More than 50% of liver transplantation recipients survive 20 years, achieve important socioeconomic milestones, and report quality of life superior to patients with liver disease or other chronic conditions."
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"Liver transplantation is a durable surgery that restores both long-term physiologic and psychologic well-being in patients with end-stage liver disease."
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"Liver transplantation is a durable surgery that restores both long-term physiologic and psychologic well-being in patients with end-stage liver disease."
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