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. 2017 Jun;55(6):557-563.
doi: 10.1055/s-0043-102580. Epub 2017 Mar 14.

The elderly liver transplant recipients: anxiety, depression, fatigue and life satisfaction

Felix Krenzien  1   2 , Nicco Krezdorn  3 , Mehmet H Morgül  1 , Georg Wiltberger  4 , Georgi Atanasov  1   2 , Hans-Michael Hau  4 , Andreas Hinz  5 , Moritz Schmelzle  1 , Michael Bartels  4 , Christian Benzing  1
Affiliations

The elderly liver transplant recipients: anxiety, depression, fatigue and life satisfaction

Felix Krenzien et al. Z Gastroenterol. 2017 Jun.

Abstract
in English, German

Introduction Older patients are neglected in clinical trials and are likely to be excluded from liver transplantation (LT). The aim of this study was to assess fatigue, anxiety, depression, and health-related quality of life (HRQoL) in elderly LT recipients. Methods Questionnaires were mailed to patients who underwent LT between 1993 and 2013. Three groups were created: patients ≥ 70, 60 - 69, and < 60 years old. Mental-health status, life satisfaction, and fatigue were assessed using, respectively, the Hospital Anxiety and Depression Scale (HADS), Questions on Life Satisfaction (FLZ-M), and the Multidimensional Fatigue Inventory (MFI-20). Results In total, 276 eligible questionnaires (40.1 %) were received out of 689 patients with a history of LT. No age-related differences were found with regard to anxiety or depression in the study sample. Patients ≥ 70 years old had significantly better life satisfaction in regards to income (p = 0.003) and work (p = 0.005) compared to patients < 60 years. The overall fatigue scores were the highest in patients < 60 years (52.7, SD = 15.8) and ≥ 70 years (52.7, SD = 17.7) compared to patients 60 - 69 years old (48.2, SD = 17.3, p = 0.037). Discussion Advanced age alone should not be considered a contraindication for LT due to potentially poor quality of life outcomes.

Einleitung Ältere Patienten werden in klinischen Studien häufig nicht berücksichtigt, eine erfolgreiche Listung zur Lebertransplantation im höheren Lebensalter ist unwahrscheinlich. Das Ziel der vorliegenden Studie liegt darin, Fatigue, Angst, Depression und gesundheitsbezogene Lebensqualität bei älteren Patienten nach Lebertransplantation zu erfassen. Methoden Die Fragebögen wurden an Patienten verschickt, welche sich zwischen 1993 und 2013 einer Lebertransplantation unterzogen haben. Psychischer Status, Lebenszufriedenheit und Fatigue wurden mithilfe des Hospital Anxiety and Depression Scale (HADS), Fragebogen zur Lebenszufriedenheit (FLZ) und dem Multidimensional Fatigue Inventory (MFI-20) erfasst. Ergebnisse Insgesamt wurden 276 (40,1 %) vollständige und auswertbare Fragebögen von 689 angeschriebenen Patienten empfangen. Es wurden keine altersabhängigen Unterschiede hinsichtlich Angst und Depression gefunden. Die Gruppe ≥ 70y hatte verglichen mit der Altersgruppe < 60y signifikant bessere Lebenszufriedenheitswerte auf der Einkommen- und Arbeit-Skala (p = 0,003 und 0,005). Die Fatigue-Werte waren in Gruppe < 60y (52,7, SD = 15,8) und Gruppe ≥ 70y (52,7, SD = 17,7) am höchsten verglichen mit Gruppe 60 – 69y (48,2, SD = 17,3, p = 0,037). Diskussion Ein höheres Lebensalter sollte nicht per se aufgrund einer unterstellten Einschränkung der Lebensqualität als Kontraindikation zur Lebertransplantation angesehen werden.

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Conflict of interest statement

Conflict of interest: Declaration of conflicting interests None of the authors has any personal or institutional financial interest in drugs, materials, or devices described in this manuscript. Funding F.K is a participant in the BIH‐Charité Clinical Scientist Program funded by the Charité –Universitätsmedizin Berlin and the Berlin Institute of Health. Author contributions C.B. conducted and supervised the study. N.K., M.H.M., G.W., G.A, H.H., and M.B. recruited the participants, collected the data, and prepared the figure and tables. F.K. and C.B. interpreted the data and wrote the manuscript. A.H. and M.S. reviewed the manuscript. Details and comments The corresponding author (CB) confirms that the manuscript has not been submitted or published in any other journal. The study was conducted and prepared according to the Declaration of Helsinki. All the co-authors agree with the publication. Sponsor's role None.

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