Quality of life after lung transplantation.

Despite the potential differences in patient characteristics, study designs, and types of instruments used, this review of the literature showed several common findings. Important improvements in QOL are reported after lung transplantation. These improvements were observed when cross-sectional comparisons were made across the cohort of candidates and recipients and during longitudinal follow-up of patients at pretransplant and posttransplant time points. The improvements in QOL after transplantation seem to be sustained for at least 1 to 3 years after transplant. Lung transplant recipients generally were satisfied with their decision to have undergone transplantation. Many issues require further clarification. Variables that may influence QOL before and after lung transplantation, such as age, sex, pretransplant diagnosis, and type of procedure performed, should be considered carefully as study variables. Carefully designed, prospective longitudinal studies with many patients would result in stronger conclusions regarding the importance of QOL assessment in lung transplantation. It would be useful for a few QOL measurement tools to emerge as standard instruments so that many centers and investigators could adopt them to use independently. Standard instruments would allow comparison of outcomes between centers and would allow meta-analyses of multiple studies using the same methodology. Interpretation of the studies would be improved because there would be improved familiarity with a few tools, rather than vague recognition of a large variety of tools.