Prospective study of functional status and quality of life before and after lung transplantation.

STUDY OBJECTIVES: To determine the impact of lung transplantation on patients' function and quality of life (QOL), 10 lung transplant patients were followed from before transplantation to 3 months after transplantation. The following variables were examined: (1) perceived functional status; (2) respiratory function; (3) moods; (4) satisfaction with overall QOL and health; and (5) thoughts about the decision to undergo lung transplantation. DESIGN: A longitudinal, small-group, repeated-measures design. SETTING: A large Midwest university medical center. MEASUREMENTS AND RESULTS: Several instruments were used to measure perceived health, QOL, functional status, and respiratory function. The perceived improvement in physical function after transplantation was accompanied by increased satisfaction with physical strength, current health, and QOL. In addition, dramatic improvements in pulmonary function were seen after transplantation (FVC, FEV(1), and forced expiratory flow at 25 to 75% of FVC); however, only the FEV(1) values significantly improved between 1 and 3 months after transplantation. For example, the FEV(1) (mean +/- SD) increased from 22 +/- 11% of predicted before transplantation to 46 +/- 12% and 55 +/- 14% of predicted at 1 month and 3 months after transplantation, respectively. Although the total number of psychological symptoms did not decrease significantly over time, the intensity and distress associated with the symptoms did. Psychological function scores did not change significantly. Ninety percent of the subjects reported being very satisfied with their transplant decision. CONCLUSIONS: Lung transplantation significantly improved the subjects' overall function and their satisfaction with their QOL and health status. However, since this report only addressed data for the first 3 months after transplantation, additional longitudinal research is needed to further elucidate the experiences and outcomes associated with lung transplantation.

Research on the quality of life of lung transplant candidates and recipients: an integrative review.

Although lung transplantation is one of the most rapidly growing areas of solid organ transplantation, there has been little research on the quality of life of lung transplant candidates or recipients. This review critiques and synthesizes the quality-of-life reports concerning these patients that have been published between January 1980 and January 1999. The purposes of this review of the literature were to (1) examine both the conceptual and operational definitions of quality of life used; (2) identify and list the instruments used to measure quality of life; (3) investigate methodologic issues; and (4) determine the state-of-the-art of research in this area. On the basis of this review, suggestions are made for future studies.

[The etiopathogenesis of chronic hepatitis in children]. / Studiu privind etiopatogenia hepatitelor cronice la copil.

The authors study the etiology of chronic hepatitis, with emphasis on the high frequency of the infection with virus B, with a chronization rate of 15-20%. Taking into account the mother fetus, transmission and the increased number of AgHBs chronic carriers, with serious consequences on hepatic affection, the authors insist on the necessity of antiviral vaccination and of the therapy for virus elimination. At the same time, pathogenetic investigations are made for the presence of nonspecific antibodies and antibodies against hepatocytic membrane, elements which prove the permanent character of the hepatic lesions by immune mechanism, induced by the virus B persistence.

[HBsAg carriers--a study performed on a closed collective of 0- to 3-year-old children]. / Purtatori de AgHBs--studiu efectuat într-o colectivitate închisa de copii 0-3 ani.

The clinical, functional-histological and mainly the therapeutical aspect in chronic hepatitis, still raises important problems in children's pathology. As the clinical aspect of the chronic liver diseases is variable and less suggestive in the early and even advanced stages in children, the authors followed--for three years--the incidence of biochemical and histological functional disturbances in a closed collectivity of children. Since no specific therapeutical possibilities exist yet, the importance for a better knowledge of epidemiology of post-viral chronic hepatitis is emphasized.