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Reduction in functional ability is significant postliver transplantation compared with matched liver disease and community dwelling controls

Lookup NU author(s): Chris Elliott, Dr James Frith, Jessie Pairman, Professor David Jones, Professor Julia Newton

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Abstract

P>We compared functional ability and symptom severity in liver transplant recipients and matched chronic liver disease (CLD) and community controls. A total of 103/140 consecutive liver transplant recipients from a single centre (73%) and matched controls completed the patient-reported functional outcome measure: Patient-Reported Outcomes Measurement Information System, Health Assessment Questionnaire (PROMIS HAQ). Symptoms frequently seen in CLD were quantified by (i) Fatigue Impact Scale (FIS), (ii) Orthostatic Grading Scale (OGS: autonomic dysfunction), (iii) Cognitive Failures Questionnaire (CFQ) and (iv) Epworth Sleepiness Scale (ESS: Daytime somnolence). Liver transplant recipients exhibited significant reduction in function (P < 0.0001) across all domains of the PROMIS HAQ suggesting that functional impairment is broad-based. Seventy-seven per cent of all postliver transplants identified some difficulty with activities of daily living. There was no relationship between PROMIS HAQ and liver biochemistry (r2 = 0.04, P = NS) or time since transplant (r2 = 0.1, P = NS). Elevation in PROMIS HAQ (and therefore functional impairment) strongly associated with symptoms, particularly fatigue, cognitive impairment and daytime somnolence. Fatigue severity was independently associated with functional impairment (FIS) (Beta 0.727, P < 0.0001). Symptoms or functional ability was not different between liver transplant recipients and matched chronic liver disease controls. Although survival postliver transplantation is improving, our cross-sectional study suggests that functional ability may not improve postliver transplantation. Further study is warranted to address the mechanisms responsible for post-transplant functional impairment and to develop effective rehabilitation regimes to maximize function following liver transplantation.


Publication metadata

Author(s): Elliott C, Frith J, Pairman J, Jones DEJ, Newton JL

Publication type: Article

Publication status: Published

Journal: Transplant International

Year: 2011

Volume: 24

Issue: 6

Pages: 588-595

Print publication date: 08/03/2011

ISSN (print): 0934-0874

ISSN (electronic): 1432-2277

Publisher: Wiley-Blackwell Publishing Ltd.

URL: http://dx.doi.org/10.1111/j.1432-2277.2011.01240.x

DOI: 10.1111/j.1432-2277.2011.01240.x


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