Is health related quality of life improved by lung transplantation?
Why is this important?
Lung transplantation has emerged as a viable treatment for patients living with end stage lung disease, including Cystic Fibrosis. While extending patients’ lives through transplant is critical, so too is improving their quality of life (QOL). For researchers, QOL is a valuable patient-centered way to measure the usefulness of lung transplant.
What did you do?
We examined quality of life scores of US lung transplant recipients participating in a multi-centered trial examining how best to prevent a virus called CMV. Study participants completed a QOL (SF-36) questionnaire, a commonly used survey to measure QOL, once prior to their transplant and at 3, 6, 9, and 12 months after lung transplant.
What did you find?
Lung transplantation improved quality of life related to physical and social functioning, and vitality. Scores increased dramatically at 3 months and continued to climb over the first year of transplant. These improvements did not differ by sex, age, or transplant procedure but did vary by transplant indication with CF patients reporting better QOL than recipients transplanted for Chronic Obstructive Pulmonary Disease or Pulmonary Fibrosis. On the other hand, QOL scores related to psychological functioning stayed the same from pre- to post-transplant.
What does this mean and reasons for caution?
While further studies are needed to understand why psychological functioning does not improve after transplant, the increase in one-year physical QOL, combined with other studies demonstrating a survival benefit, provides good support for lung transplant as a viable treatment for end stage lung disease. Our findings stem from a secondary analysis of US clinical trial participants and therefore may not be representative of all patients undergoing transplant.
Additional studies using repeated measurements of QOL over the transplant lifespan are needed to understand if the QOL benefits seen in the first year persist over time. Efforts at understanding and improving psychological functioning after transplant are also needed so that the maximal benefits of transplant may be realized.