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Patient‐reported outcomes in liver transplant recipients with hepatocellular carcinoma
Author(s) -
Kensinger Clark D.,
Feurer Irene D.,
O'Dell Heather W.,
LaNeve David C.,
Simmons Lindsey,
Pinson C. Wright,
Moore Derek E.
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12785
Subject(s) - medicine , hepatocellular carcinoma , depression (economics) , anxiety , liver transplantation , quality of life (healthcare) , single center , mental health , transplantation , gastroenterology , psychiatry , nursing , economics , macroeconomics
Abstract Background The effect of awarding MELD exception points for hepatocellular carcinoma ( HCC ) on patient‐reported outcomes ( PRO s) is unknown. We evaluated the physical and mental health‐related quality of life ( HRQOL ) and symptoms of anxiety and depression in liver transplant recipients with HCC compared to patients without HCC . Methods The single‐center sample measured PRO s before and after transplant, which included 1521 multisurvey measurement points among 502 adults (67% male, 28% HCC , follow‐up time: <1–131 months). Data were analyzed using multivariable mixed‐effects models. Results Longitudinal PRO values did not differ between persons who received HCC exception points and those who did not have HCC . Patients with HCC who did not receive exception points had reduced physical HRQOL ( P =.016), a late decline in mental HRQOL , and delayed reduction in anxiety (time‐by‐outcome interaction P <.050) compared to patients with HCC who received exception points. Conclusion Transplant recipients who received HCC exception points had PRO s that were comparable to those of patients without HCC , and reported better physical HRQOL and reduced symptoms of anxiety compared to patients with HCC who did not receive exception points. These analyses demonstrate the impact of HCC exception points on PRO s, and may help inform policy regarding HCC exception point allocation.