Background: Quality of life (QOL) is an important but understudied outcome after lung transplantation. Previous cross-sectional, single-center studies suggest improved QOL, but few prior longitudinal multicenter data exist regarding the effect of transplantation on the patient's QOL. Methods: We hypothesized that lung transplantation confers a 1-year QOL benefit in both physical and psychologic well-being; we further hypothesized that the magnitude of benefit would vary by sex, native disease, age, or type of transplant operation. To test these hypotheses, we conducted a secondary analysis using QOL data prospectively and serially measured with the Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36) in a multicenter cytomegalovirus prevention clinical trial. Linear mixed-effects models were used to assess the impact of transplantation on the recipient's QOL. Results: Over the first year after lung transplantation, the SF-36 Physical Component Score signifi- cantly increased an average of 10.9 points from baseline levels (P < .0001). A positive benefit was observed for all native diseases; however, the magnitude varied slightly by native disease (P = .04) but not by sex (P = .35), age (P = .06), or transplant type (P = .30). In contrast, the SF-36 Mental Component Score did not change from baseline (P = .36) and remained well below population norms. Conclusions: Our results demonstrate that lung transplantation confers clinically important QOL benefits in physical domains but not in psychologic well-being. A better understanding of the barriers to psychologic well-being after transplant is critical to enhancing the benefits of lung transplantation.
Bibliographical noteFunding Information:
Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Ms Pieper receives AstraZeneca funding for time and travel. Dr Mark receives consulting funds from Sanofi-Aventis US LLC; AstraZeneca; Medtronic, Inc; and Novartis AG. He has received grants from the National Heart, Lung, and Blood Institute; National Institutes of Health/Agency for Healthcare Research and Quality; Procter & Gamble; Pfizer, Inc; Medtronic, Inc; Alexion Pharmaceuticals; and Medicure Inc. Dr Palmer receives current funding from the National Heart, Lung, and Blood Institute: P50 HL107180, R34 HL105422-01, and K24-091140-01, in addition to The Biomarker Factory, Roche Organ Transplantation Research Foundation, and the Lung Transplant Foundation. Dr Palmer's institution previously received funding from Roche Pharmaceuticals to conduct an investigator-initiated multicenter study of CMV prevention coordinated by the Duke Clinical Research Institute. Dr Palmer has served on the Speakers Bureau for Forest Laboratories, Inc and as a Consultant to Novartis AG. Ms Copeland and Dr Vock have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.