785 The aim of the study was to explore pain and other factors that could influence health related quality of life (HRQOL) in heart-, kidney- and liver transplant recipients during the first two years after transplantation and to define similarities and/or differences in the three groups. Method A total of 76 patients, 18-60 years old, undergoing heart-(n=18), kidney(n=34) or liver transplantation (n=24) between 1995-1997 with a follow-up of 6-24 months were included. HRQOL and pain were investigated by using SF-36, Hospital Anxiety and Depression Scale and the Pain-O-Meter (POM). Results Overall the patients show satisfactory HRQOL with no difference between the groups(figure). Fifty-three percent of all patients reported bodily pain. The most common locations were the hands, feet and back and sensory experiences were burning, stabbing or dull pain. There was a correlation between number of rejections and total score for POM-VAS (p<0.05)(rho 0.47). There was also a correlation between number of rejection episodes and the total pain intensity score for POM-WDS (p<0.05)(rho 0.48). Patients with pain scored higher in the area of depression (p<0.05).Figure: Median profile. In the area of role physical (RP) the difference was significant (p<0.05). The health areas represent general health (GH), physical functioning (PF), bodily pain (BP), vitality (VT), social functioning (SF), role-emotional (RE) and mental health (MH).Conclusion Bodily pain is an important problem after organ transplantation even in patients with good allograft function.

To gather information regarding how to best assist liver transplant recipients in improving their self-care capacity and well-being, we investigated their total health situation. A retrospective, cross-sectional survey with up to a 10-year follow-up concerning experienced health and quality of life after liver transplantation (LTX) was conducted. The aim of this study was to provide descriptive data on the experienced health and health-related quality of life (HRQOL) after LTX and to evaluate whether the pretransplantation medical conditions affected these parameters. All patients who had undergone LTX, were alive at the time of the study, and had a follow-up of more than 6 months (n = 134) were asked to complete three self-administered questionnaires. The response rate was 95% (n = 120). There was no correlation between pretransplantation Child-Pugh score and HRQOL after LTX. Liver transplant recipients were more limited in their physical health than healthy subjects but were equal in social functioning and mental health. Twenty-six percent suffered from severe bodily pain. A significant difference was reported in all health areas, with the exception of vitality and social functioning, between employed and unemployed transplant recipients. Liver transplant recipients suffered from limited physical functioning many years after transplantation. Their social functioning and mental health were not negatively affected. This study emphasizes that bodily pain and difficulties in performing regular activities because of physical illness are problems frequently experienced by liver transplant recipients. Copyright (C) 1998 by the American Association for the Study of Liver Diseases.

In insulin-dependent (Type 1) diabetes mellitus (IDDM) the development of nephropathy is partly due to genetic susceptibility. Previously one study has demonstrated a relationship between a Hind III restriction polymorphism of the collagen IV alpha 1-chain gene and diabetic nephropathy. The aim of the present study was to evaluate such as association in a case-control study including 207 Danish IDDM patients: 116 with nephropathy (urinary albumin excretion rate (AER) > 300 mg 24 h(-1)) and 91 without nephropathy (AER < 30 mg 24 h(-1)). Using genomic DNA, Hind III restriction fragment length analysis revealed a bi allele polymorphism visualized by Southern hybridization with a cDNA probe recognizing the collagen IV alpha 1-chain gene. No differences in genotype frequencies or allele frequencies were demonstrated comparing patients with and without nephropathy: p = 0.39 and p = 0.96, respectively. Neither were there any difference in genotype frequencies or allele frequencies when the patients were stratified according to the presence of proliferative retinopathy: p = 0.44 and p = 0.84, respectively. Pooling the diabetic groups revealed genotype frequencies and allele frequencies comparable to those found in 57 healthy unrelated Danish individuals. We conclude that in a Danish IDDM population a Hind III restriction polymorphism of the collagen IV alpha 1-chain gene is not associated with diabetic nephropathy, diabetic retinopathy or with diabetes per se.