Prospective study of functional status and quality of life before and after lung transplantation

Study objectives: To determine the impact of lung transplantation on patients' function and quality of life (QOL), 10 lung transplant patients were followed from before transplantation to 3 months after transplantation. The following variables were examined: (1) perceived functional status; (2) respiratory function; (3) moods; (4) satisfaction with overall QOL and health; and (5) thoughts about the decision to undergo lung transplantation. Design: A longitudinal, small-group, repeated-measures design. Setting: A large Midwest university medical center. Measurements and results: Several instruments were used to measure perceived health, QOL, functional status, and respiratory function. The perceived improvement in physical function after transplantation was accompanied by increased satisfaction with physical strength, current health, and QOL. In addition, dramatic improvements in pulmonary function were seen after transplantation (FVC, FEV₁, and forced expiratory flow at 25 to 75% of FVC); however, only the FEV₁ values significantly improved between 1 and 3 months after transplantation. For example, the FEV₁ (mean ± SD) increased from 22 ± 11% of predicted before transplantation to 46 ± 12% and 55 ± 14% of predicted at 1 month and 3 months after transplantation, respectively. Although the total number of psychological symptoms did not decrease significantly over time, the intensity and distress associated with the symptoms did. Psychological function scores did not change significantly. Ninety percent of the subjects reported being very satisfied with their transplant decision. Conclusions: Lung transplantation significantly improved the subjects' overall function and their satisfaction with their QOL and health status. However, since this report only addressed data for the first 3 months after transplantation, additional longitudinal research is needed to further elucidate the experiences and outcomes associated with lung transplantation.