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Original Research: Transplantation |

Impact of Lung Transplantation on Recipient Quality of LifeQuality of Life After Lung Transplantation: A Serial, Prospective, Multicenter Analysis Through the First Posttransplant Year

C. Ashley Finlen Copeland, MSW; David M. Vock, PhD; Karen Pieper, MS; Daniel B. Mark, MD, MPH; Scott M. Palmer, MD, MHS, FCCP
Author and Funding Information

From the Department of Medicine (Ms Finlen Copeland and Dr Palmer), Duke University Medical Center, Durham; the Duke Clinical Research Institute (Ms Pieper and Drs Mark and Palmer), Durham; and North Carolina State University (Dr Vock), Raleigh, NC.

Correspondence to: C. Ashley Finlen Copeland, MSW, Duke University Medical Center, Box 103002, Durham, NC 27710; e-mail: Ashley.finlen.copeland@duke.edu


Data in this manuscript were presented at the American Thoracic Society International Conference, May 13-18, 2011, Denver, CO.

Funding/Support: The randomized cytomegalovirus prevention trial was funded by Roche Pharmaceuticals as an investigator-initiated trial, coordinated by the Duke Clinical Research Institute.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(3):744-750. doi:10.1378/chest.12-0971
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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 significantly 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.

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