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Illness cognitions and health-related quality of life in liver transplant patients related to length of stay, comorbidities and complications

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Abstract

Purpose

Illness cognitions regarding helplessness and acceptance are known to play a role in health-related quality of life (HRQoL). Our study examined the evolution of these illness cognitions and the physical (PQoL) and mental QoL (MQoL) in liver transplantation (LT) patients over time in relation to pre- and postoperative clinical factors.

Methods

We performed an analytical cross-sectional study using self-report questionnaires at 4 timeframes: preLT, postLT0–3 m, postLT1y, and postLT2y. T-test was used to identify the influence of different clinical factors related to the LT on postLT2y QoL and illness cognition. Linear mixed models were used to determine evolution.

Results

PostLT patients showed significant less helplessness and more acceptance cognitions. PQoL and MQoL decreased postLT0–3 m, then started to increase and are highest at postLT1y. Patients with preLT ascites showed significantly less helplessness postLT2y, while patients with a low preLT MELD score < 20 showed a significant better MQoL postLT2y. Biliary complications and re-transplantation were associated with more helplessness and a worse PQoL postLT1y–2y. Length of stay in ICU and hospital was negatively correlated with illness cognitions and PQoL and MQoL postLT1y.

Conclusions

Our findings confirm that liver transplant patients have improvement of illness cognitions and mental and physical HRQoL at 1 and 2 years after liver transplantation. A postoperative period without complications and with short stay in ICU and in hospital, is important to achieve PQoL and feeling less helpless, while the MQoL is influenced by acceptance and preLT PQoL. Multidisciplinary approach preLT and postLT should be standard care.

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Data availability

The authors declare our data and material is transparent.

Code availability

Not applicable.

Abbreviations

AIH:

Auto-immune hepatitis.

ALD:

Alcoholic liver disease.

ALF:

Acute liver failure.

CMV:

Cytomegalovirus.

DM:

Diabetes mellitus.

ESLD:

End-stage liver disease.

HBV:

Hepatitis B virus.

HCV:

Hepatitis C virus.

ICU:

Intensive care unit.

ICQ:

Illness cognitions questionnaire.

INR:

International normalized ratio.

HCC:

Hepatocellular carcinoma.

HRQoL:

Health-related quality of life.

LoS:

Length of stay.

LT:

Liver transplantation.

MELD:

Model for end-stage liver disease.

MQoL:

Mental quality of life.

NASH:

Non-alcoholic steatotic hepatitis.

NAFLD:

Non-alcoholic liver failure disease.

PBC:

Primary biliary cirrhosis.

PostLT:

Post-liver transplantation.

PQoL:

Physical quality of life.

PreLT:

Pre-liver transplantation.

PSC:

Primary sclerosing cholangitis.

SD:

Standard deviation.

SF-36:

Short-form health survey

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Funding

No funding or financial support was received for this work.

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Authors and Affiliations

  1. Department of General and Hepatobiliary Surgery and Transplantation, University Ghent, Ghent, Belgium

    Louis Onghena, Frederik Berrevoet & Aude Vanlander

  2. Department of Internal Medicine and Pediatrics, University Ghent, Ghent, Belgium

    Hans Van Vlierberghe, Xavier Verhelst, Eric Hoste & Carine Poppe

Authors
  1. Louis Onghena
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  2. Frederik Berrevoet
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  3. Aude Vanlander
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  4. Hans Van Vlierberghe
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  5. Xavier Verhelst
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  6. Eric Hoste
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  7. Carine Poppe
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Contributions

Louis Onghena: participated in research design, writing of the paper, performance of the research, data analysis and contributed new reagents or analytic tools. Frederik Berrevoet participated in research design, writing of the paper and contributed new reagents or analytic tools. Aude Vanlander participated in research design and contributed new reagents or analytic tools. Hans Van Vlierberghe participated in research design and contributed new reagents or analytic tools. Xavier Verhelst participated in research design and contributed new reagents or analytic tools. Eric Hoste participated in research design and contributed new reagents or analytic tools. Carine Poppe participated in research design, writing of the paper, data analysis and contributed new reagents or analytic tools.

Corresponding author

Correspondence to Louis Onghena.

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The authors declare no conflicts of interest.

Ethical approval

Our study was approved by the Ethics Committee on 04/09/2013. Study trademark: 2013/630. Belgian registration number: B670201318188. Approval is attached.

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Data were anonymized when questionnaires were digitalized.

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Onghena, L., Berrevoet, F., Vanlander, A. et al. Illness cognitions and health-related quality of life in liver transplant patients related to length of stay, comorbidities and complications. Qual Life Res 31, 2493–2504 (2022). https://doi.org/10.1007/s11136-022-03083-5

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