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Quality of Life for Pancreas Recipients

  • Chapter
Transplantation of the Pancreas

Abstract

Patients coping with the restrictions of the diabetic lifestyle and concerned about secondary complications are increasingly turning to pancreas transplantation (PTx). Over 13,000 pancreas transplants have been reported worldwide,1 about 10,000 in the United States alone. The vast majority of these (about 95%) are combined with renal transplants, usually as simultaneous pancreas—kidney (SPK) transplants. Patients with diabetes and uremia seek to escape the double burdens of dialysis and exogenous insulin therapy through transplantation. National statistics show that SPK affords a long-term survival advantage over a cadaver kidney transplant alone (KTA) (about 10 years) and over dialysis (about 15 years).2 Recent and younger patients are predicted to have the most benefit, as technical success and early posttransplant survival with SPK transplants improved significantly over the past decade.1,2 Studies describing the quality of life (QOL) outcomes of PTx recipients have been regularly reported since 1989. With few exceptions, all QOL reports have focused on adults with insulin-dependent diabetes mellitus (IDDM) and renal dysfunction. A number of reviews specific to PTx3–6 or transplants in general7’8 have synthesized the findings from many of these studies. This review will update an earlier review,4 by incorporating reports from the last 5 years. This review will address the following four questions:

  1. 1.

    What aspects of QOL change from pretransplant to posttransplant with PTx?

  2. 2.

    Which QOL benefits are transitory, sustained, or enhanced over the long term?

  3. 3.

    Are the QOL outcomes of PTx patients any different from the outcomes of kidney transplant (KTx) recipients with IDDM?

  4. 4.

    How do the outcomes of PTx recipients differ from the QOL reports of age-matched samples from the general population?

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References

  1. Bland BJ, ed. International Pancreas Transplant Registry Newsletter, vol. 12. Minneapolis: University of Minnesota; 2000.

    Google Scholar 

  2. Ojo AO, Meier-Kriesche HU, Hanson JA, et al. The impact of simultaneous pancreas-kidney transplantation on long-term patient survival. Transplantation 2001; 71: 82–90.

    Article  PubMed  CAS  Google Scholar 

  3. Bartlett ST, delaTorre A, Johnson LB, et al. Long-term pancreatic function: Potential benefits. Transplant Proc 1996; 28: 2128 2130.

    Google Scholar 

  4. Gross CR, Limwattananon C, Matthees BJ. Quality of life after pancreas transplantation: A review. Clin Transplant 1998; 12: 351–361.

    PubMed  CAS  Google Scholar 

  5. Manske CL. Risks and benefits of kidney and pancreas transplantation for diabetic patients. Diabetes Care 1999;22:B114-B120

    PubMed  Google Scholar 

  6. Pirsch JD, Andrews C, Hricik DE, et al. Transplantation for the nephrologist-pancreas transplantation for diabetes mellitus. Am J Kidney Dis 1996; 27: 444–450.

    Article  PubMed  CAS  Google Scholar 

  7. Molzahn AE. Quality of life after organ transplantation. J Adv Nurs 1991; 16: 1042–1047.

    Article  PubMed  CAS  Google Scholar 

  8. Dew MA, Switzer GE, Goycoolea JM, et al. Does transplantation produce quality of life benefits? Transplantation 1997; 64: 1261–1273.

    Article  PubMed  CAS  Google Scholar 

  9. Leplege A, Hunt S. The problem of quality of life in medicine. JAMA 1997; 278: 47–50.

    Article  PubMed  CAS  Google Scholar 

  10. World Health Organization. Constitution of the World Health Organization: Chronicle of the World Health Organization 1. 1947; 1: 1–29.

    Google Scholar 

  11. Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med 1996; 334: 835–840.

    Article  PubMed  CAS  Google Scholar 

  12. Carr AJ, Gibson B, Robinson PG. Measuring quality of life: Is quality of life determined by expectations or experience? Br Med J 2001; 322: 1240–1243.

    Article  CAS  Google Scholar 

  13. McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247–263.

    Article  PubMed  CAS  Google Scholar 

  14. Guyatt G, Feeny D, Patrick D. Issues in quality-of-life measurement in clinical trials. Contr Clin Trials 1991; 12: 815–90S.

    Google Scholar 

  15. Grieco A, Long CJ. Investigation of the Karnofsky Performance Status as a measure of quality of life. Health Psychol 1984; 3: 129–142.

    Article  PubMed  CAS  Google Scholar 

  16. O’Boyle CA, McGee H, Hickey A, et al. Individual quality of life in patients undergoing hip replacement. Lancet 1992; 339: 1088–1091.

    Article  PubMed  Google Scholar 

  17. Evans RW, Manninen DL, Garrison LP Jr, et al. The quality of life of patients with end-stage renal disease. N Engl J Med 1985; 312: 553–559.

    Article  PubMed  CAS  Google Scholar 

  18. Dew MA. Quality-of-life studies: Organ transplantation research as an exemplar of past progress and future directions. J Psychosomat Res 1998; 44: 189–195.

    Article  CAS  Google Scholar 

  19. Whiting JF and the Transplantation Outcomes Research Group. Standards for economic and quality of life studies in transplantation. Transplantation 2000; 70: 1115–1121.

    Article  Google Scholar 

  20. Kaplan RM, Atkins CJ, Timms R Validity of a quality of wellbeing scale as an outcome measure in chronic obstructive pulmonary disease. J Chron Dis 1984; 37: 85–95.

    Article  PubMed  CAS  Google Scholar 

  21. Postulart D, Adang EM. Response shift and adaptation in chronically ill patients. Med Decision Making 2000; 20: 186–193.

    Article  CAS  Google Scholar 

  22. Brazier J, Usherwood T, Harper R, et al. Deriving a preference-based single index from the UK SF-36 health survey. J Clin Epidemiol 1998; 51: 1115–1128.

    Article  PubMed  CAS  Google Scholar 

  23. Hathaway DK, Hartwig MS, Crom DB, et al. Identification of quality-of-life outcomes distinguishing diabetic kidney-alone and pancreas-kidney recipients. Transplant Proc 1995; 27: 30653066.

    Google Scholar 

  24. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473–483.

    Article  PubMed  Google Scholar 

  25. Ware JE Jr, Kosinski MA, Keller SD. A 12-item short-form health survey. Construction of scales and preliminary tests of reliability and validity. Med Care 1996; 34: 220–233.

    Article  PubMed  Google Scholar 

  26. Hunt SM, McEwen J, McKenna SP. Measuring health status: A new tool for clinicians and epidemiologists. J Roy Coll Gen Pract 1985; 35: 185–188.

    CAS  Google Scholar 

  27. Bergner M, Bobbitt RA, Carter WB, et al. The Sickness Impact Profile: Development and final revision of a health status measure. Med Care 1981; 19: 787–805.

    Article  PubMed  CAS  Google Scholar 

  28. McDowell I, Newell C. Measuring Health: A Guide to Rating Scales and Questionnaires New York: Oxford University Press; 1996.

    Google Scholar 

  29. Bentley FR, Jung S, Garrison RN. Neuropathy and psychosocial adjustment after pancreas transplant in diabetics. Transplant Proc 1990; 22: 691–695.

    PubMed  CAS  Google Scholar 

  30. Johnson JL, Schellberg J, Munn SR, et al. Does pancreas transplantation really improve the patient’s quality of life? Transplant Proc 1990; 22: 575–576.

    PubMed  CAS  Google Scholar 

  31. Nathan DM, Fogel H, Norman D, et al. Long-term metabolic and quality of life results with pancreatic/renal transplantation in insulin-dependent diabetes mellitus. Transplantation 1991; 52: 85–91.

    Article  PubMed  CAS  Google Scholar 

  32. Stratta RJ, Taylor RJ, Ozaki CF, et al. A comparative analysis of results and morbidity in type 1 diabetics undergoing preemptive versus postdialysis combined pancreas-kidney transplantation. Transplantation 1993; 55: 1097–1103.

    Article  PubMed  CAS  Google Scholar 

  33. Hathaway DK, Abell T, Cardoso S, et al. Improvement in autonomic and gastric function following pancreas-kidney versus kidney-alone transplantation and the correlation with quality of life. Transplantation 1994; 57: 816–822.

    Article  PubMed  CAS  Google Scholar 

  34. Hathaway DK, Hartwig MS, Milstead J, et al. A prospective study of changes in quality of life reported by diabetic recipients of kidney-only and pancreas-kidney allografts. J Transplant Coord 1994; 4: 12–17.

    Google Scholar 

  35. Hathaway DK, Hartwig MS, Milstead J, et al. Improvement in quality of life reported by diabetic recipients of kidney-only and pancreas-kidney allografts. Transplant Proc 1994; 26: 512–514.

    PubMed  CAS  Google Scholar 

  36. Adang EMM, Engel GL, van Hooff JP, et al. Comparison before and after transplantation of pancreas-kidney and pancreas-kidney with loss of pancreas-a prospective controlled quality of life study. Transplantation 1996; 62: 754–758.

    Article  PubMed  CAS  Google Scholar 

  37. Gross CR, Limwattananon C, Matthees B, et al. Impact of transplantation on quality of life in patients with diabetes and renal dysfunction. Transplantation 2000; 70: 1736–1746.

    Article  PubMed  CAS  Google Scholar 

  38. Gross CR, Kangas JR, Lemieux AM, et al. One-year change in quality of life profiles in patients receiving pancreas and kidney transplants. Transplant Proc 1995; 27: 3067–3068.

    PubMed  CAS  Google Scholar 

  39. Zehrer CL, Gross CR. Comparison of quality of life between pancreas/kidney and kidney transplant recipients: 1-year follow-up. Transplant Proc 1994; 26: 508–509.

    PubMed  CAS  Google Scholar 

  40. Jacobson A, Barofsky I, Cleary P, et al. Reliability and validity of a diabetes quality of life measure for the Diabetes Control and Complications Trial (DCCT). Diabetes Care 1988; 11: 725–732.

    Article  Google Scholar 

  41. Sutherland DE, Gruessner RW, Dunn DL, et al. Lessons learned from more than 1,000 pancreas transplants at a single institution. Ann Surg 2001; 233: 463–501.

    Article  PubMed  CAS  Google Scholar 

  42. Stratta RJ, Weide LG, Sindhi R, et al. Solitary pancreas transplantation. Experience with 62 consecutive cases. Diabetes Care 1997; 20: 362–368.

    Article  PubMed  CAS  Google Scholar 

  43. Esmatjes E, Ricart MJ, Fernandez-Cruz L, et al. Quality of life after successful pancreas-kidney transplantation. Clin Transplant 1994; 8: 75–78.

    PubMed  CAS  Google Scholar 

  44. Piehlmeier W, Bullinger M, Kirchberger I, et al. Evaluation of the quality of life of patients with insulin-dependent diabetes mellitus before and after organ transplantation with the SF-36 Health Survey. Eur J Surg 1996; 162: 933–940.

    PubMed  CAS  Google Scholar 

  45. Secchi A, Martinenghi S, Castoldi R, et al. Effects of pancreas transplantation on quality of life in type I diabetic patients undergoing kidney transplantation. Transplant Proc 1998; 30: 339342.

    Google Scholar 

  46. Nakache R, Tyden G, Groth CG. Long-term quality of life in diabetic patients after combined pancreas-kidney transplantation or kidney transplantation. Transplant Proc 1994; 26: 510–511.

    PubMed  CAS  Google Scholar 

  47. Tyden G, Bolinder J, Solders G, et al. A 10-year prospective study of IDDM patients subjected to combined pancreas and kidney transplantation or kidney transplantation alone. Transplant Proc 1998; 30: 332.

    Article  PubMed  CAS  Google Scholar 

  48. Groth CG, Bolinder J, Solders G, et al. Diabetic patients subjected to combined pancreas and kidney transplantation or kidney transplantation alone: Outcome after 5 to 10 years. Transplant Proc 1998; 30: 3413.

    Article  PubMed  CAS  Google Scholar 

  49. Matas AJ, McHugh L, Payne WD, et al. Long-term quality of life after kidney and simultaneous pancreas-kidney transplantation. Clin Transplant 1998; 12: 233–242.

    PubMed  CAS  Google Scholar 

  50. Najarian JS, Gruessner AC, Drangstveit MB, et al. Insulin independence for more than 10 years after pancreas transplantation. Transplant Proc 1998; 30: 1936–1937.

    Article  PubMed  CAS  Google Scholar 

  51. Zehrer CL, Gross CR. Patient perceptions of benefits and concerns following pancreas transplantation. Diabetes Educ 1994; 20: 216–220.

    Article  PubMed  CAS  Google Scholar 

  52. Nakache R, Tyden G, Groth CG. Quality of life in diabetic patients after combined pancreas-kidney or kidney transplantation. Diabetes 1989; 38: S40 - S42.

    Google Scholar 

  53. Secchi A, Di Carlo V, Martinenghi S, et al. Effect of pancreas transplantation on life expectancy, kidney function and quality of life in uraemic type 1 (insulin-dependent) diabetic patients. Diabetologia 1991; 34: S141 - S144.

    Article  PubMed  Google Scholar 

  54. Brons IGM, Cane RY, Jamieson NV, et al. Results with combined kidney and paratopic segmental-pancreas transplantation. Diabetes 1989; 38: 18–20.

    PubMed  Google Scholar 

  55. Kiebert GM, van Oosterhout ECAA, Lemkes HHPJ, et al. Quality of life after combined renal-pancreatic transplantation. Transplant Proc 1994; 26: 517.

    PubMed  CAS  Google Scholar 

  56. Kiebert GM, van Oosterhout ECAA, van Bronswijk H, et al. Quality of life after combined kidney-pancreas or kidney transplantation in diabetic patients with end-stage renal disease. Clin Transplant 1994; 8: 239–245.

    PubMed  CAS  Google Scholar 

  57. Voruganti LNP, Sells RA. Quality of life of diabetic patients after combined pancreatic-renal transplantation. Clin Transplant 1989; 3: 78–82.

    Google Scholar 

  58. Holohan TV. Simultaneous pancreas-kidney and sequential pancreas-after-kidney transplantation. Health Tech Assess 1995; 4: 1–53.

    Google Scholar 

  59. Milde FK, Hart LD, Zehr PS. Pancreatic transplantation: Impact on the quality of life of diabetic renal transplant recipients. Diabetes Care 1995; 18: 93–95.

    Article  PubMed  CAS  Google Scholar 

  60. Zehr PS, Milde FK, Hart LK, et al. Impact of pancreas transplantation on quality of life of diabetic renal transplant recipients. Transplant Proc 1994; 26: 520–521.

    PubMed  CAS  Google Scholar 

  61. Zehrer CL, Gross CR. Quality of life of pancreas transplant recipients. Diabetologia 1991;34: S 145-S 149.

    Google Scholar 

  62. Gross CR, Zehrer CL. Health-related quality of life outcomes of pancreas transplant recipients. Clin Transplant 1992; 6: 165–171.

    PubMed  CAS  Google Scholar 

  63. Gross CR, Zehrer CL. Impact of the addition of a pancreas to quality of life in uremic diabetic recipients of kidney transplants. Transplant Proc 1993; 25: 1293–1295.

    PubMed  CAS  Google Scholar 

  64. Adang EMM, Kootstra G, Engel GL, et al. Do retrospective and prospective quality of life assessments differ for pancreas-kidney transplant recipients? Transplant Int 1998; 11: 11–15.

    Article  CAS  Google Scholar 

  65. Calman KC. Quality of life in cancer patients-an hypothesis. J Med Ethics 1984; 10: 124–127.

    Article  PubMed  CAS  Google Scholar 

  66. Ware JE. SF-36 Health Survey: Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center; 1993.

    Google Scholar 

  67. Patrick DL, Deyo RA. Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989; 27: S217 - S232.

    Article  PubMed  CAS  Google Scholar 

  68. Bruce DS, Newell KA, Josephson MA, et al. Long-term outcome of kidney-pancreas tranplant recipients with good graft function at one year. Transplantation 1996; 62: 451–456.

    Article  PubMed  CAS  Google Scholar 

  69. Russell CH, Megaard I. The General Social Survey, 1972–1986: The State of the American People. Recent Research in Psychology. New York: Springer-Verlag; 1988.

    Google Scholar 

  70. Lee CM, Scandling JD, Krieger NR, et al. Outcomes in diabetic patients after simultaneous pancreas-kidney versus kidney alone transplantation. Transplantation 1997; 64: 1288–1294.

    Article  PubMed  CAS  Google Scholar 

  71. Hathaway DK, Winsett RP, Milstead EJ, et al. Quality of life outcomes associated with variable posttransplant prednisone dosing regimens. J Transplant Coord 1996; 6: 64–68.

    CAS  Google Scholar 

  72. Winsett RP and the Posttransplant Quality of Life Intervention Study Group. Posttransplant quality of life: A decade of descriptive studies leading to practice interventions. J Transplant Coord 1998; 8: 236–240.

    Google Scholar 

  73. Settle M. Increased compliance through targeted behavioral interventions. Transplant Proc 1999; 31: 45S.

    Google Scholar 

  74. Stratta RJ, Taylor RJ, Ozaki CF, et al. The analysis of benefit and risk of combined pancreatic and renal transplantation versus renal transplantation alone. Surg Gynecol Obstet 1993; 177: 163–171.

    PubMed  CAS  Google Scholar 

  75. Stratta RJ, Sudan R, Sudan D Long-term outcomes in simultaneous kidney-pancreas transplant recipients. Transplant Proc 1998; 30: 1564–1565.

    Article  PubMed  CAS  Google Scholar 

  76. Piehlmeier W, Bullinger M, Kirchberger I, et al. Prospective study of the qualify of life in type I diabetic patients before and after organ transpantation. Transplant Proc 1994; 26: 522–523.

    PubMed  CAS  Google Scholar 

  77. Corry RJ, Zehr P. Quality of life in diabetic recipients of kidney transplants is better with the addition of the pancreas. Clin Transplant 1990; 4: 238–241.

    PubMed  CAS  Google Scholar 

  78. Bentdal OH, Fauchald P, Brekke IB, et al. Rehabilitation and quality of life in diabetic patients after successful pancreas-kidney transplantation. Diabetologia 1991; 34: 5158 - S159.

    Article  Google Scholar 

  79. Piehlmeier W, Bullinger M, Nusser J, et al. Quality of life in type 1 (insulin-dependent) diabetic patients prior to and after pancreas and kidney transplantation in relation to organ function. Diabetologia 1991; 34: S150 - S157.

    Article  PubMed  Google Scholar 

  80. Piehlmeier W, Bullinger M, Nusser J, et al. Quality of life in diabetic patients prior to or after pancreas transplantation in relation to organ function. Transplant Proc 1992; 24: 871–873.

    PubMed  CAS  Google Scholar 

  81. Satterly A, Cox D, Reynolds L, et al. Life activities following simultaneous pancreatic/renal transplantation: A pilot study. J Transplant Coord 1991; 1: 15–18.

    Google Scholar 

  82. Zehr PS, Milde FK, Hart LK, et al. Life quality of pancreatic transplant recipients: A comparison. Transplant Proc 1992; 24: 850–851.

    PubMed  CAS  Google Scholar 

  83. Zehr PS, Milde FK, Hart LK, et al. Pancreas transplantation: Assessing secondary complications and life quality. Diabetologia 1991;34:S138-S 140.

    Google Scholar 

  84. Milde FK, Hart LK, Zehr PS. Quality of life of pancreatic transplant recipients. Diabetes Care 1992; 15: 1459–1463.

    Article  PubMed  CAS  Google Scholar 

  85. Kinkhabwala M, Wilkinson A, Danovitch G, et al. The role of whole organ pancreas transplantation in the treatment of type I diabetes. Am J Surg 1996; 171: 516–520.

    Article  PubMed  CAS  Google Scholar 

  86. Schareck WD, Hopt UT, Geisler F, et al. Quality of life after combined pancreas-kidney transplantation. Transplant Proc 1994; 26: 518–519.

    PubMed  CAS  Google Scholar 

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Authors
  1. Cynthia R. Gross
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  2. Angelika C. Gruessner
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  3. Charoen Treesak
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Editors and Affiliations

  1. Department of Surgery, University of Minnesota, 55455, Minneapolis, Minnesota, USA

    Rainer W. G. Gruessner MD (Professor) & David E. R. Sutherland MD, PhD (Professor) (Professor) &  (Professor)

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Gross, C.R., Gruessner, A.C., Treesak, C. (2004). Quality of Life for Pancreas Recipients. In: Gruessner, R.W.G., Sutherland, D.E.R. (eds) Transplantation of the Pancreas. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-4371-5_17

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  • DOI: https://doi.org/10.1007/978-1-4757-4371-5_17

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