Quality of life 10 years after liver transplantation: The impact of graft histology

Table 1 Relationship between various parameters at the time of liver transplantation and the incidence of hepatic steatosis on 10-year post-liver transplantation biopsy

	All subjects n = 72	No HS n = 48	HS n = 24	P1
Age (yr)	35 ± 19	32 ± 21	42 ± 12	0.04
Gender (female)	52%	60%	71%	NS
Disease
Acute hepatic failure	24%	27%	17%	NS
Primary biliary cirrhosis	25%	25%	25%	NS
HBV-related cirrhosis	8%	6%	12%	NS
Autoimmune cirrhosis	7%	6%	8%	NS
Biliary atresia	5%	8%	0%	NS
HCV-related cirrhosis	12%	6%	25%	NS
Metabolic disease (Wilson disease)	1%	2%	0%	NS
Alcohol related cirrhosis	1%	2%	0%	NS
Primary sclerosing cholangitis	4%	4%	4%	NS
Cryptogenic cirrhosis	2%	4%	0%	NS
Hepatocellular carcinoma	8%	8%	8%	NS
ABO compatible	97%	96%	100%	NS
Donor age (years)	27 ± 11	27 ± 12	27 ± 10	NS
Donor gender (female)	41%	42%	39%	NS
Urgency	25%	27%	21%	NS
Cold ischemic time (min)	410 ± 212	406 ± 215	429 ± 214	NS
Reperfusion biopsy2
Steatosis (≥ 10%)	18%	15%	22%	NS
% of steatosis	24 ± 15	31 ± 16	16 ± 8	NS
Reperfusion lesions
Mild	26%	31%	17%	NS
Moderate to severe	60%	50%	79%	NS

Continuous data are represented as mean ± SD, and categorical data as percentage.

¹Comparison between HS and No HS;

²Reperfusion biopsy not done in 10 cases (9 in Non HS group and 1 in HS group). HS: Hepatic steatosis; NS: Not significant; HCV: Hepatitis C virus.

Table 2 Relationship between various parameters at 10-year post-liver transplantation and the incidence of hepatic steatosis on 10-year post-liver transplantation biopsy

	All subjects n = 72	No HS n = 48	HS n = 24	P1
Age at the time of survey	49 ± 15	47 ± 15	53 ± 12	NS
≥ 60 yr aged patients	28%	27%	29%	NS
Histological lesions
Steatosis	33%	-	100%
Macrovacuolar	28%	-	82%
Microvacuolar	1%	-	4%
Combined Mac-Mic	4%	-	14%
Initial and 10-yr maintained steatosis	8% (5 pat.)	0%	22%	0.002
Fibrosis (F1-F4)	53%	44%	71%	0.03
F1-F2	40%	35%	50%	NS
F3-F4	13%	8%	21%	NS
Combined fibrosis-steatosis	24%	0%	71%	< 0.0001
HCV(+) Fibrosis	44%	31%	71%	< 0.001
Bile duct lesions	36%	42%	25%	NS
Minimal change	23%	27%	17%	NS
Other potential steatosis factors
BMI (kg/m2)	22.4 ± 3.8	22.3 ± 3.9	22.6 ± 3.4	NS
Underweight (BMI ≤ 18.5)	13%	17%	4%
Normal weight (BMI = 18.5-24.9)	69%	65%	79%	NS
Overweight (BMI = 25-29.9)	14%	14%	13%
Obesity (BMI ≥ 30)	4%	4%	4%
HCV infection (de novo or recurrence)	57%	46%	79%	0.007
Arterial hypertension	53%	52%	54%	NS
Glycemia (mmol/L)	5.4 ± 2.0	5.1 ± 0.9	6.2 ± 3.2	NS
Diabeties mellitus	10%	8%	13%	NS
Maintenance immunosuppresssion
Cyclosporine A	96%	96%	96%	NS
Dosage (mg)	129.8 ± 58.1	135.0 ± 61.5	119.5 ± 50.4	NS
Prednisolone	93%	96%	88%	NS
Dosage (mg)	6.8 ± 3.1	6.9 ± 3.2	6.7 ± 2.9	NS
Azathioprine	43%	40%	50%	NS
Dosage (mg)	48.4 ± 15.7	51.3 ± 15.5	43.8 ± 15.5	NS

Continuous data are represented as mean ± SD, and categorical data as percentage.

¹Comparison between HS and No HS. HS: Hepatic steatosis; NS: Not significant; BMI: Body mass index.

Table 3 Social life factors and hepatic steatosis at 10-year biopsy

	All subjects n = 72	No HS n = 48	HS n = 24	P1
Work
Employed	33%	39%	23%	NS
Homemaker	13%	17%	4%	NS
Student full/part-time	3%	4%	0%	NS
Unemployed	20%	19%	23%	NS
Retired	30%	21%	50%	0.03
No. of years worked	17.9 ± 12.7	16.4 ± 12.6	20.9 ± 12.5	NS
Alcohol and smoking
Alcohol consumption	21%	17%	30%	NS
No. of drinks2/d in drinkers	1.1 ± 0.3	1.0 ± 0.0	1.2 ± 0.4	NS
Tobacco smokers	17%	15%	21%	NS
Cigarettes/d in smokers	1.9 ± 0.7	2.1 ± 0.7	1.6 ± 0.9	NS

Continuous data are represented as mean ± SD, and categorical data as percentage.

¹Comparison between HS and No HS;

²One drink = 1 bottle of beer or 1 glass of wine or 1 mixed drink. HS: Hepatic steatosis; NS: Not significant.

Table 4 Univariate analysis of subjective variables associated with hepatic steatosis at 10-year biopsy

QOL criteria	Univariate P
Physical distress
Muscle weakness	0.04
Abdominal pains or discomfort	< 0.0001
Abdominal swelling or bloating	0.04
Joint aches or pains	< 0.001
Headaches	0.03
Poor or blurred vision	0.03
Change in facial appearance	< 0.001
Fluid retention or swelling of ankles	0.02
Psychological distress
Sleeplessness or insomnia	0.03
Nervousness, anxiety	0.009
Feeling depressed, sad or blue	< 0.01
Low satisfaction with life as a whole	0.02
Personal function
Health currently limits the kind of vigorous activities such as running, heavy lifting or sport	< 0.001
Social and role function
Decreased interest in sex	0.003
Problem with sex life	0.04
General health perception
Bodily pain during the last month	< 0.01

Table 5 Multivariate analysis of independent factors of hepatic steatosis at 10-year biopsy

Factors	Multivariate P
Objective factors
Retirement	0.04
Hepatitis C virus infection (de novo or recurrence)	< 0.01
Subjective factors
Abdominal pains or discomfort	< 0.01
Joint aches or pains	0.04