Impact of different immunosuppressive regimens on the health-related quality of life following orthotopic liver transplantation

Clin Transplant. 2015 Dec;29(12):1081-9. doi: 10.1111/ctr.12631. Epub 2015 Nov 4.

Abstract

Background: The influence of immunosuppression on the recipients' quality of life (QoL) is of major importance after OLT and has not yet been evaluated.

Methods: The impact of different immunosuppression regimens after OLT was evaluated in 275 patients using the Short Form 36 (SF-36) survey. The following immunosuppressive strategies were compared: (a) CNI, (b) mTOR inhibitors, and (c) mTOR combined with CNI. All regimens were prescribed alone (mono) or in combination (+) with prednisolone and/or mycophenolate mofetil (MMF).

Results: Highest scores were evident in patients in the mTOR+ group. There were significantly higher values for general health perceptions (GH, p = 0.049), vitality (VIT, p = 0.020), and physical component summary (PCS, p = 0.041) when compared to CNImono and for GH (p = 0.042) and VIT (p = 0.043), when compared to mTORmono. Early conversion to mTOR inhibitors (<two months after OLT) was associated with higher values for 7 of 10 scales, when compared to a late conversion (>two months after OLT), with a statistically significant improvement for the dimension role-emotional (RE, p = 0.027).

Discussion: mTOR inhibitor-based regimens appear to have beneficial effects on QoL after OLT, especially after an early conversion.

Keywords: Quality of Life; SF-36; early conversion; immunosuppression; liver transplantation.

MeSH terms

  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Graft Rejection / epidemiology
  • Graft Rejection / prevention & control*
  • Graft Survival
  • Humans
  • Immunosuppression Therapy
  • Immunosuppressive Agents / therapeutic use*
  • Incidence
  • Liver Diseases / surgery*
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prognosis
  • Quality of Life*
  • Risk Factors

Substances

  • Immunosuppressive Agents