Pre-transplant quality of life does not predict survival after lung transplantation

Currently, the goal of lung transplantation is not only to improve survival but also includes improvement of health-related quality of life (HRQL). Limited knowledge is available about the value of HRQL before lung transplantation with regard to predicting survival after lung transplantation. To maximize the benefits of transplantation, it is essential to gain knowledge about variables that predict both length and quality of survival. In this study we sought to determine whether HRQL before transplantation predicts survival after lung transplantation.

For each of the 200 lung transplant recipients included in this study, the HRQL questionnaire completed at the date closest to the transplant date was selected. Measures included were: the Nottingham Health Profile (NHP); State-Trait Anxiety Inventory (STAI); Self-Rating Depression Scale (SDS)-Zung; Karnofsky Performance Scale; and Index of Well-Being (IWB). Cox regression models were used to determine whether pre-transplant scores predicted post-transplant survival.

Survival rates at 1, 3 and 5 years were 85%, 73% and 69%, respectively. Mean scores on all pre-transplant HRQL measures were unfavorable compared with reference values for the general population. No significant predictors for survival after lung transplantation were found.

Results suggest that scores on the various HRQL measures before transplantation did not predict survival after lung transplantation. The present results do not support the usefulness of pre-transplant HRQL measures for the selection of lung transplant candidates or their urgency for transplantation.