Quality of life among liver transplantation recipients before and after surgery: A single-center longitudinal study

Quality of Life and Its Determinants in Liver Transplantation Candidates: A Missed Link in Liver Care Program during the Waiting Time for Liver Transplantation

Background

The health-related quality of life (HRQOL) in the before liver transplantation (LT) stage has not been studied as much as that after the LT stage. We aimed to assess HRQOL and its determinants before the LT stage.

Methods

As a cross-sectional study, HRQOL of all adult patients (n=632) referred to the LT center of Shiraz, Iran in 2018-2019 were assessed. Demographic, socioeconomic, medical, and paraclinical data were requested. Physical (PCS) and mental (MCS) aspects of HRQOL were assessed using the SF36 questionnaire. Univariable, multivariable (linear regression), and confirmatory factor analysis were performed utilizing SPSS 20 and Mplus 6.1 software. P<0.05 was considered to be significant.

Results

The mean age of the patients was 47.6±12.3 years, while 414 (65.6%) were men, and the mean, score of the model for end-stage liver disease (MELD) was 18.36±5.58. The mean score of QOL, PCS, and MCS was 50.01±21.73, 46.23±23.23, and 53.78±23.91 (out of 100), respectively. Vitality had the most association with HRQOL, while role limitations had the lowest. The multivariable analysis revealed that unemployment (P<0.001), anemia (P=0.005), weight loss (P=0.005), diabetes mellitus (DM) (P=0.009), low MELD score (P=0.027), and drug use (P=0.03) were the significant determinants of HRQOL, respectively.

Conclusion

The present study showed that HRQOL in the LT candidates was at the intermediate level, while their PCS and MCS are at the low and moderate levels, respectively. Furthermore, physical performance, job status, anemia, weight loss, MELD score, DM, and drug use should be considered as the significant determinants of HRQOL in the LT candidates.

Medication Non-adherence Prevalence and Determinants in Children and Adolescents with Chronic Liver Diseases

Background: Medication adherence is one of the most important challenges in chronic diseases. Objectives: In this study, we investigated medication adherence prevalence among children with chronic liver diseases. Methods: A total of 160 children with chronic liver disease were enrolled in our study. We evaluated medication adherence using the 8-item Morisky Medication Adherence Scale (MMAS-8) and classified them based on the scores (score < 6 = low adherence, scores 6 - 8 = medium adherence, and > 8 = high adherence). Logistic regression recognized final influencing variables on adherence. Results: Of 160 patients, 84 (52.5%) were female, and the mean age of patients was 11.2 ± 4.4 years. Also, 56 participants (35%) were high adherers, and 66 (41.25%) were low adherers. The most common reason for low adherence was forgetfulness in 37 patients (23.13%) and low access to medication in 21 subjects (13.13%). In multivariate logistic regression, age, housing status, and underlying disease were significantly associated with medication adherence. Conclusions: Almost half of the children with chronic liver disease demonstrated low medication adherence. Age, housing status, and underlying disease were significantly associated with medication adherence. We should implement programs to reduce medication non-adherence among children with chronic liver disease.