The quality of survival after liver transplantation

In an attempt to determine the quality of survival after LT, we conducted a survey of our adult patients and the parents of our pediatric patients who are surviving more than 6 months after LT. Our data demonstrate that employment status is significantly improved after LT. The significant decreases in frequency and duration of hospitalizations is of course important to prospective employers. As one might expect, the significant increase in activity tolerance was associated with similar improvements in the patients' impression of their quality of life after LT. The better preoperative status of many children is demonstrated by their level of activity tolerance before LT. Hospitalizations were also infrequent in the 6-month period before LT. This is due in part to our practice of making such patients a high priority. The scarcity of pediatric donors makes it imperative to begin a search for a suitable donor at the first sign of deterioration in the status of a child on the waiting list. We are quite gratified by the growth data of our pediatric patients. The children with growth failure in our series were all being treated with high-dose steroids for chronic rejection. We are now prospectively studying cognitive development in our children and hope for similarly gratifying results. Improvements in many aspects of LT now provide the patient with a high likelihood of survival. Our data indicate that the patient can anticipate that the quality of that survival will be excellent.