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a The UK
Cardiothoracic Transplant Audit, Clinical Effectiveness Unit, The Royal
College of Surgeons of England, London, UK, b Department
of Economics, City University, London, UK
Correspondence to: Mr A J Murday, Director of Intrathoracic Transplantation, St George's Hospital, London SW17 0QT, UK ajmurday{at}sghms.ac.uk
Received 25 April 2000; Returned to authors 18 September 2000; Revised version received 6 October 2000; Accepted for publication 4 December 2000
BACKGROUND
The EuroQol
is a generic questionnaire developed to provide a simple method for
assigning utility values to health. This study examines the
applicability of the EuroQol to the measurement of quality of life in
single, bilateral, and heart-lung transplantation.
METHODSA cross
sectional study was performed in 87 patients awaiting lung
transplantation and in 255 transplant recipients attending follow up
clinics in four transplant units.
RESULTSIn the waiting
list group 61% reported extreme problems in at least one of the five
EuroQol quality of life domains compared with 20% single lung
recipients, 4% bilateral lung recipients, and 2% heart-lung
recipients at 3 or more years after transplantation. The mean utility
value of patients on the waiting list was 0.31. In comparison, utility
values for recipients 3 years after transplantation were 0.61 for
single, 0.82 for bilateral, and 0.87 for heart-lung transplants. The
utility scores and health profiles of bilateral and heart-lung
recipients were consistently superior to those of single lung
recipients. Problems in all five domains were more frequent in single
lung recipients. Subjective assessment with a visual analogue scale
showed a similar trend.
CONCLUSIONSThe
EuroQol is a simple method of deriving a single utility value for
quality of life and is responsive to changes after lung transplantation. It is worth considering as a means of monitoring quality of life after transplantation and as an index of quality of
survival in research studies in solid organ transplantation. These
data suggest that quality of life after transplantation of one lung is
inferior to that after transplantation of two lungs.
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