Skip to main content


Log in

Health-related quality of life of transplant recipients: a comparison between lung, kidney, heart, and liver recipients

Quality of Life Research Aims and scope Submit manuscript



Quality of life and psychological responses to transplantation are constructs used to assess various psychosocial aspects after organ transplantation. The purpose of this study is to compare physical, psychological, social, and environmental quality of life between recipients of four organs: liver, lung, heart, and kidney.


In order to compare the four types of quality of life and emotional responses post-transplant, HRQOL and TxEQ questionnaires were administered to 427 transplant recipients.


Heart and liver recipients report significantly higher health-related quality of life than lung and kidney recipients. Heart and lung patients report significantly fewer concerns and worries than liver and kidney patients. New additional variables were explored in our study: psychological connection to the living donor/deceased donor's family and commitment to them. We also found that heart recipients feel their personality traits changed, postoperative.


The contribution of our study was the finding that ethno-religious and psychosocial variables have a positive effect on four dimensions of HRQOL. It may be useful to design psychological support interventions specifically adapted to patients after organ transplantation that aim at enhancing patients' HRQOL and alleviating negative emotional responses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2


  1. WHO. WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment; Field trial version. Geneva: World Health Organization; 1996. Retrieved July 4, 2019, from

  2. Sarac, N., Ambühl, P., Irani, S., et al. (2008). Psychological response and quality of life after transplantation: A comparison between heart, lung, liver and kidney recipients. Swiss Medical Weekly,138(33–34), 477–483.

    PubMed  Google Scholar 

  3. Revicki, D. A., Osoba, D., Faiclough, D., et al. (2000). Recommendations on health-related quality of life research to support labeling and promotional claims in United States. Quality of Life Research,9, 887–900.

    Article  CAS  Google Scholar 

  4. Trevizan, F. B., Miyazaki, M. C. D. O. S., Silva, Y. L. W., & Roque, C. M. W. (2017). QOL, depression, anxiety and coping after heart transplantation. Brazilian Journal of Cardiovascular Surgery,32(3), 162–170.

    PubMed  PubMed Central  Google Scholar 

  5. Liu, H., Feurer, I. D., Dwyer, K., et al. (2009). Effects of clinical factors on psychosocial variables in renal transplant recipients. Journal of Advanced Nursing,65(12), 2585–2596.

    Article  Google Scholar 

  6. Thabut, G., & Mal, H. (2017). Outcomes after lung transplantation. Journal of Thoracic Disease,9(8), 2684.

    Article  Google Scholar 

  7. Bleisch, B., Schuurmans, M. M., Klaghofer, R., et al. (2019). Health-related quality of life and stress-related post-transplant trajectories of lung transplant recipients: A three-year follow-up of the Swiss Transplant Cohort Study. Swiss Medical Weekly.

    Article  PubMed  Google Scholar 

  8. McAdams-DeMarco, M. A., Olorundare, I. O., Ying, H., et al. (2018). Frailty and post kidney transplant health-related quality of life. Transplantation,102(2), 291.

    Article  Google Scholar 

  9. Villeneuve, C., Laroche, M. L., Essig, M., et al. (2016). Evolution and determinants of health-related quality-of-life in kidney transplant patients over the first 3 years after transplantation. Transplantation,100(3), 640–647.

    Article  CAS  Google Scholar 

  10. Doering, L. V., Chen, B., Deng, M., et al. (2018). Perceived control and health-related quality of life in heart transplant recipients. European Journal of Cardiovascular Nursing,17(6), 513–520.

    Article  Google Scholar 

  11. Ågren, S., Sjöberg, T., Ekmehag, B., et al. (2017). Psychosocial aspects before and up to 2 years after heart or lung transplantation: Experience of patients and their next of kin. Clinical Transplantation,31(3), e12905.

    Article  Google Scholar 

  12. Burra, P., & Ferrarese, A. (2019). Health-related quality of life in liver transplantation: Another step forward. Transplant International,32(8), 792–793.

    PubMed  Google Scholar 

  13. Ziegelmann, J. P., Griva, K., Hankins, M., et al. (2002). The Transplant Effects Questionnaire (TxEQ): The development of a questionnaire for assessing the multidimensional outcome of organ transplantation—Example of end stage renal disease (ESRD). British Journal of Health Psychology,7(4), 393–408.

    Article  Google Scholar 

  14. Muehrer, R. J., & Becker, B. N. (2005). Psychosocial factors in patients with chronic kidney disease: Life after transplantation: New transitions in quality of life and psychological distress. Seminars in Dialysis,18(2), 124–131.

    Article  Google Scholar 

  15. Achille, M. A., Ouellette, A., Fournier, S., Vachon, M., & Hébert, M. J. (2006). Impact of stress, distress and feelings of indebtedness on adherence to immunosuppressants following kidney transplantation. Clinical Transplants,20(3), 301–306.

    Article  Google Scholar 

  16. McAdams-DeMarco, M.A., Olorundare, I.O., Ying, H., Warsame, F., Haugen, C.E., Hall, R., ... & Segev, D.L.(2018) Frailty and postkidney transplant health-related quality of life. Transplantation. 102(2), 291.‏

  17. Taskintuna, N., & Özçürümez, G. (2011). End-stage renal disease and psychological trauma: Shame and guilt in hemodialysis patients, transplantation recipient and donor candidates, and controls. Archives of Neuropsychiatry,48(4), 249–254.

    Article  Google Scholar 

Download references


The research project received no funding.

Author information

Authors and Affiliations



PA and YBC participated in research design. YBC PA and MT participated in the writing of the paper. MT participated in the performance of the research. YBC participated in the data analysis of the project. MT and YBC participated in data analysis. PA and MT reviewed the draft of the paper. YBC and MT approved the final draft of the paper.

Corresponding author

Correspondence to Ya’arit Bokek-Cohen.

Ethics declarations

Conflict of interest

The authors declare thay they have no conflicts of interest.

Ethical approval

Ethical approval was obtained from the IRB of the Academic College of Tel Aviv Jaffa.

Informed consent

All participants signed an informed consent form.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tarabeih, M., Bokek-Cohen, Y. & Azuri, P. Health-related quality of life of transplant recipients: a comparison between lung, kidney, heart, and liver recipients. Qual Life Res 29, 1631–1639 (2020).

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: