Quality of Life After Liver Transplantation-Results from a Large European Multinational Survey

Background/Objectives: Liver transplantation (LT) is life-saving, yet its long-term impact on quality of life (QoL) remains complex and incompletely characterized. A standardized, transplant-specific patient-reported outcome measure (PROM) for routine use in European LT recipients is currently lacking. Methods: This descriptive, cross-sectional survey assessed QoL among 794 adult LT recipients across 22 European countries using a purpose-built, 48-item transplant-specific questionnaire developed within the European Society for Organ Transplantation (ESOT) Patient Inclusion Initiative. The instrument has not undergone psychometric validation and was used as an exploratory research survey. Respondents were grouped by time since LT (0-5, 6-12, and ≥13 years). Group comparisons used chi-square tests with Benjamini-Hochberg correction, followed by multivariable analyses adjusted for relevant sociodemographic factors. Results: Median time since LT was 6 years (IQR 3-12). After multiple-testing correction, alcohol consumption (q < 0.001), feeling that life is worth living (q = 0.029), and changes in social life (q = 0.029) differed between groups. In multivariable analysis, only alcohol consumption remained independently associated with time since LT, with progressively higher odds at 6-12 years (aOR 4.18, 95% CI 2.56-6.82) and ≥13 years (aOR 7.09, 95% CI 4.27-11.77) compared with 0-5 years. Physical health, emotional functioning, sexual health, satisfaction with care and medication adherence did not differ between groups. Conclusions: This large European survey provides hypothesis-generating information on self-reported well-being after LT. Alcohol consumption was the only outcome independently associated with time since transplantation. These findings support prospective studies using psychometrically validated patient-reported measures.