Health-related quality of life may improve after transplantation in pancreas-kidney recipients

Pancreas-kidney transplantation (PKT) may significantly improve quality of life (HRQOL) in patients with type 1 diabetes. We have assessed the changes felt by PKT patients, using the Gastrointestinal Quality of Life Index (GIQLI) and EuroQol-5D questionnaires. Patients were asked to compare how their HRQOL had changed from pre-transplantation to the last visit. The 60 men and 66 women enrolled had a mean follow-up of five yr; 84.1% with both grafts, 15.9% with one graft functioning. In all domains of EuroQol-5D scores improved after PKT, as well as the visual analogue scale health state (from 38% to 84%, p<0.001; effect size 3.34). In GIQLI, physical function was felt better after PKT than before (14.83 +/- 3.86 vs. 7.86 +/- 4.43, p<0.001; effect size 1.68); the same was observed for psychological status, social function, and GI complaints. Concerning the burden of medical treatment, the score significantly improved (from 1.31 to 3.63, p<0.001, effect size 2.02). The rate of unemployed patients decreased after PKT (from 50.8% to 36.5%, p<0.001). Multivariate analysis showed that having only one functioning graft was associated with worse HRQOL scores (B=-5.157, p=0.015). In conclusion, for all assessed domains, patients reported a significant improvement in HRQOL after PKT. Maintenance of the two grafts functioning predicted higher improvement of HRQOL scores.