Impact of different immunosuppressive regimens on the health-related quality of life following orthotopic liver transplantation

Background: The influence of immunosuppression on the recipients' quality of life (QoL) is of major importance after OLT and has not yet been evaluated. Methods: The impact of different immunosuppression regimens after OLT was evaluated in 275 patients using the Short Form 36 (SF-36) survey. The following immunosuppressive strategies were compared: (a) CNI, (b) mTOR inhibitors, and (c) mTOR combined with CNI. All regimens were prescribed alone (mono) or in combination (+) with prednisolone and/or mycophenolate mofetil (MMF). Results: Highest scores were evident in patients in the mTOR+ group. There were significantly higher values for general health perceptions (GH, p = 0.049), vitality (VIT, p = 0.020), and physical component summary (PCS, p = 0.041) when compared to CNImono and for GH (p = 0.042) and VIT (p = 0.043), when compared to mTORmono. Early conversion to mTOR inhibitors (< two months after OLT) was associated with higher values for 7 of 10 scales, when compared to a late conversion (> two months after OLT), with a statistically significant improvement for the dimension role-emotional (RE, p = 0.027). Discussion: mTOR inhibitor-based regimens appear to have beneficial effects on QoL after OLT, especially after an early conversion.