Determinants of Quality of Life After Lung Transplantation

ABSTRACT

Background: The purpose of this study was to examine clinical and non- clinical determinants of quality of life (QoL) in lung transplant recipients (LTR).

Methods: QoL was measured cross-sectional in 152 LTR (4.5±3.2 years after lung transplantation [LTx]; 95 [63%] double LTx; 80 [53%] female; age 50±11.9 years; 28 [18%] bronchiolitis obliterans syndrome (BOS) stage ≥ 1) using the SF-36, the “Quality of Life Profile for Chronic Diseases Questionnaire” as well as the “St. Georges` Respiratory Questionnaire”. Gender, age, body mass index (BMI), time after LTx, procedure type, underlying disease, marital- and professional status and exercise capacity (6-minute walk test, 6MWT) were tested for their predictive value by non-parametric significance tests and ANOVA and ANCOVA.

Results: There was a significant correlation with higher physical QoL scores for age < 48 years (p<0.05), a BMI of 21.0 - 25.2 kg/m² (p<0.05), a 6MWT≥ 430m (p<0.001), for cystic fibrosis patients (p<0.05) without BOS (p<0.05) and who go to work (p=0.018). Females boasted a superior social health (p=0.04) and less respiratory symptoms (p=0.023). Double LTx was a significant predictor for both, mental and physical health (p<0.05). Subsequent analysis of covariance revealed only BMI (p=0.024), BOS stage (p<0.001), underlying disease (p=0.01) and exercise capacity according to 6MWT (p<0.001) as significant predictors for QoL independent of age.

Conclusion: The study results suggest that returning to normal BMI and improving exercise capacity seem to be important therapeutic approaches to enhance QoL after LTx. Future investigations should focus on prophylaxis and therapy of BOS to further optimize QoL after LTx.

Keywords:

Lung transplantation, quality of life, bronchiolitis obliterans syndrome.