Promjena kvalitete života bolesnika s cirozom jetre nakon transplantacije

doctoral thesis

• Title (english): Quality of life change in patients with liver cirrhosis after transplantation
• Author: Nino Kunac; VIAF: 305796100
• Mentor: Tajana Filipec Kanižaj (mentor)
• Committee member: Rudolf Gregurek (predsjednik povjerenstva)
• Committee member: Boris Vucelić (član povjerenstva)
• Committee member: Leonardo Patrlj (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2020-05-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Cilj: Kvaliteta života primatelja jetre jedan je od najvažnijih parametara uspjeha transplantacijskog liječenja. Cilj ovog istraživanja bio je ispitati utjecaj prije i poslijetransplantacijskih kliničko-laboratorijskih obilježja i kvalitete presatka jetre na kvalitetu života primatelja jetre. -----
Metode i ispitanici: U istraživanje je uključeno 100 bolesnika s cirozom jetre dobi između 18 i 65 godina, transplantiranih u periodu 2015. do 2017. godine. Kvaliteta života procijenjena je generičkim -SF-36 i specifičnim upitnikom - CLDQ, koje su ispitanici ispunjavali prije transplantacije te 6 i 12 mjeseci nakon transplantacije. -----
Rezultati: U svim domenama SF-36 upitnika, osim u BP (p=0,582), te u svim domenama CLDQ upitnika, pokazano je da postoji statistički značajno poboljšanje kvalitete života uspoređujući stanje prije i nakon transplantacije jetre. Univarijatnom analizom se pokazalo da su faktori s pozitivnim utjecajem na kvalitetu života nakon transplantacije muški spol, etilična ciroza te viši CTP i MELD rezultat, dok su arterijska hipertenzija, HCC i viši DRI faktori s negativnim utjecajem. Spearmanova korelacija pokazala je statistički značajnu pozitivnu povezanost MELD rezultata s kvalitetom života 12 mjeseci nakon transplantacije u MCS domeni SF-36 upitnika (r=0,267, p=0,007), te u ukupnom rezultatu CLDQ upitnika (r=0,274, p=0,006). Multivarijatna raščlamba pokazala je da je značajno bolja kvaliteta života nakon transplantacije prisutna kod ispitanika s cirozom etilične geneze (p=0,037), te kod onih koji nemaju arterijsku hipertenziju (p=0,042). -----
Zaključak: Nakon transplantacije jetre dolazi do značajnog poboljšanja kvalitete života bolesnika. Faktori s pozitivnim utjecajem na kvalitetu života nakon transplantacije su muški spol, etilična ciroza te viši CTP i MELD rezultat, dok negativno utječu arterijska hipertenzija, HCC i viši DRI rezultat.

Abstract (english)

Background: Quality of life is one of the most important success parameters after liver transplantation. The aim of this study was to evaluate the impact of pre- and post-transplantation clinical and laboratory parameters and liver graft quality on liver recipients quality of life. -----
Methods: The study comprised 100 patients with liver cirrhosis aged >18 and <65 years, transplantated in the period between year 2015 and 2017. Quality of life was assessed with a generic- SF-36 and specific questionnaire- CLDQ, at 3 times: before, and at 6 and 12 months after transplantation. -----
Results: We observed a significant improvement in quality of life after liver transplantation in all domains of SF-36, except in BP (p=0,582), and CLDQ questionnaire. Univariate analysis found that factors with positive effect on post-transplant quality of life are male gender, ethylic cirrhosis and higher CTP and MELD score, while arterial hypertension, HCC and higher DRI are factors with negative effect. Spearman analysis showed a significant positive correlation between MELD and results 12 months after transplantation, in the MCS SF-36 domain (r=0,267, p=0,007), and overall CLDQ domain (r=0,274, p=0,006). Multivariate analysis found significantly better post-transplant quality of life according to CLDQ overall domain, in patients with ethylic cirrhosis (p=0,037) and those without arterial hypertension (p=0,042). -----
Conclusion: Quality of life improved significantly after liver transplantation. Factors that positively affect post-transplant quality of life are male gender, ethylic cirrhosis and higher CTP and MELD score. Arterial hypertension, HCC and higher DRI are factors that adversely affect post-transplant quality of life.

• Keywords: ciroza jetre; transplantacija jetre; kvaliteta života
• Keywords (english): liver cirrhosis; liver transplantation; quality of life
• Language: croatian
• URN:NBN: urn:nbn:hr:105:680306
• Promotion: 2021
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Catalog URL: https://katalog.nsk.hr/F/19IT7Y755V1NXQJPHCLYSQGPF6BLAPPF179HQ7FAXXMYBYGMV5-09419?func=find-e&request=Promjena+kvalitete+%C5%BEivota+bolesnika+s+cirozom+jetre+nakon+transplantacije&find_scan_code=FIND_NAS&adjacent=N&local_base=MF_WEB&x=72&y=13&filter_code_1=WLN&filter_request_1=&filter_code_2=WYR&filter_request_2=&filter_code_3=WYR&filter_request_3=&filter_code_4=WFM&filter_request_4=
• Type of resource: Text
• Extent: 103 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-04 09:36:55