Chest
Volume 105, Issue 3, March 1994, Pages 911-917
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Preliminary Report
Measuring the Quality of Life Before and After Bilateral Lung Transplantation in Patients With Cystic Fibrosis

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Lung transplantation is an important topic today in healthcare policy because the technique is new and costly. One of the important issues in the evaluation of lung transplantation is quality of life. The quality of life after lung transplantation must be relatively high compared with other forms of medical care to legitimize the high costs of transplantation. Quantifying the quality of life after lung transplantation and other medical therapies is possible with general measurements of quality of life. In a pilot study of six patients with cystic fibrosis, the quality of life, both before and after lung transplantation, was measured by the following five instruments: (1) standard gamble, (2) time trade-off, (3) the Karnofsky performance status, (4) the EuroQol visual analog scale, and (5) the Nottingham health profile. This pilot study demonstrates that the introduced methodology is feasible. The preliminary results suggest that the improvement in quality of life for patients with cystic fibrosis after bilateral lung transplantation is comparable to the improvement in quality of life after heart transplantation.

Section snippets

Disease-Specific vs General Measurements

Two different approaches to evaluate the quality of life before and after lung transplantation are (1) disease-specific measurements and (2) general measurements.2 Physicians are most familiar with the disease-specific measurements. In the case of lung diseases, examples of disease-specific measurements are walking speed, the use of oxygen cylinders, and lung volume. Disease-specific measurements are very sensitive to small changes in quality of life. For this reason, the disease-specific

Methods

A pilot study was set up in order to estimate the quality of life before and after bilateral lung transplantation in patients with cystic fibrosis. At the moment of measurement, eight patients with cystic fibrosis were participating in the lung transplantation program at the Antonius Hospital in Nieuwegein, the Netherlands. Before the pilot study started, 2 patients had died after transplantation; 1 died 6 days after transplantation and the other 96 days after transplantation. These two

ACKNOWLEDGMENT

We thank Gouke J. Bonsel, M.D., for his constructive criticism and Ms. Gretchen Vroege-McGrath for her linguistic assistance.

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