Fatigue and physical function after orthotopic liver transplantation

Over the last two decades, orthotopic liver transplantation (OLT) has become an established treatment for acute and chronic liver failure. OLT impacts not only on survival, but also on health-related quality of life. This study was undertaken to describe the self-rated health of Danish liver transplant recipients, compare their self-rated health against that of the general population, and to investigate associations between sex, age, diagnosis, time after OLT, and postoperative physical function and fatigue. All adult surviving liver transplant recipients who underwent OLT in Copenhagen, Denmark, from 1990 to 1998 (n = 154) were contacted by mail and asked to complete a self-administered questionnaire. The questionnaire contained the 36-Item Short Form Health Survey, the Multidimensional Fatigue Inventory, the Hospital Anxiety and Depression Scale, and questions on marital status, education, and work. The response rate was 84.4% (n = 130). Liver transplant recipients reported poorer self-rated health than the general population in physical, but not in mental, health areas. One health aspect, fatigue, was investigated in great detail. This study found that liver transplant recipients experienced physical, rather than mental, fatigue. Diagnosis was found to be a predictor of postoperative physical function and fatigue because patients with an alcoholic or cryptogenic cirrhosis background had significantly poorer physical function and experienced more physical fatigue than liver transplant recipients with other diagnoses. Work status and survival time after OLT had significant effects on postoperative physical function and fatigue. Working and having undergone transplantation 4 to 5 years previously were associated with significantly better physical function and less physical fatigue than not working and having undergone transplantation 1 to 3 years previously. This study suggests that liver transplant recipients experience physical, rather than mental, impairment and fatigue and that diagnosis, work status, and survival time after OLT are associated with physical function and fatigue. (Liver Transpl 2002;8:251-259.)