Loris Pironi¹, Janet Baxter², Augusto Lauro³, Mariacristina Guidetti¹, Federica Agostini¹, Rossella Petitto¹, Chiara Zanfi³, Antonio Daniele Pinna³

¹Center for Chronic Intestinal Failure, University of Bologna, Bologna, Italy; ²Scottish Home Parenteral Nutrition Network, Ninewells Hospital and Medical School, Dundee, United Kingdom; ³Liver and Multiorgan Transplant Unit, University of Bologna, Bologna, Italy

Background: A treatment-specific quality of life questionnaire for adult patients on HPN (HPN-QOL^©) has been recently validated (Baxter J, JPEN 2010;34:131). In order to investigate the quality of life on HPN and after ITx using comparable instruments, the HPN-QOL^© was adapted to ITx recipients, by modifying the text of some items, without changing number of either the items or the scales. A cross-sectional study was performed to compare patients on HPN or who had undergone ITx.

Methods: All the patients currently followed at the same Hospital were enrolled. Exclusion criteria were: age >= 60 years and hospitalization at time of assessment.The questionnaire was administered at time of a scheduled visit at the outpatient clinic or was mailed at patient home.The HPN-QOL^© is composed of both multi-item scales and single-item measures. These include 8 functional scales, 9 symptom scales, 3 global health status / quality of life scales and 2 single items. The Mann-Whitney U test was used for the statistical analysis.

Results: Thirty-three HPN-patients and 18 ITx recipients received the questionnaires. All the HPN-patients (12 M, 21 F; median age: 46 yrs) and 16 ITx recipients (10 M, 6 F, p=0.08; median age 40.5 yrs, P=0.11) participated in the study. Two ITx recipients had a central venous catheter for hydration or  HPN. ITx recipients showed a better score in the following scales: ability to holiday/travel (p=0.040, physical function (p=0.038), ability to eat/drink (p=0.042), emotional function (p<0.001), gastrointestinal symptoms (p<0.001), stoma management/bowel movements (P=0.001), global health status/quality of life (p<0.001). No significant difference was observed in the other scales: general health, coping, employment, sexual function, body image, body weight, immobility, fatigue, sleep pattern, non-gastrointestinal pain, financial issues.

Conclusions: Specific and comparable questionnaires showed that several domains of the quality of life are improved after ITx in comparison with HPN.