Fewer than half return to work after liver transplant in France

Last Updated: 2015-11-24

By Shannon Aymes

NEW YORK (Reuters Health) - Fewer than half of liver recipients in France return to work after their transplant, according to a new study.

Dr. Marika Rudler, of La Pitie-Salpetriere Hospital at the University Pierre and Marie Curie in Paris, and colleagues examined the rate of employment after liver transplantation in a French liver transplant center and reported their findings online November 9 in the European Journal of Gastroenterology & Hepatology.

Patients in their study had received a liver transplant between January 2000 and April 2011, between the ages of 18 to 65.

After exclusions and with a response rate of 76.6%, the study included 157 participants (73.2% male; mean age, 49).

The posttransplant employment rate was 33.8% (n=53) at one year, 43.3% (n=68) at two years, and 43.9% (n=69) at a mean follow-up of 6.1 years.

On univariate analysis, factors associated with post-liver transplant employment included higher level of education (p<0.001), male sex (p<0.001), age below 40 at transplant (p=0.02), having children less than 18 years old at the time of transplant (p=0.01), and having a sedentary job before transplant (p=0.007). Likewise, not being affiliated with the universal health coverage was a factor associated with employment after liver transplantation (p=0.001).

Reasons for not returning to work included early retirement, unemployment, disability, alcoholism, and physician recommendation.

The problem is not limited to liver recipients in France. In a 2011 paper in Liver Transplantation, Huda et al reported on 21,942 U.S. transplant patients, finding that only 5,360 (24.4%) were employed within 24 months of transplantation. (That paper is here: http://bit.ly/1OeSgVd.)

"The most important message is that organ recipients should always be encouraged to go back to work, as unemployment is associated with depression and lower self-esteem. Many patients in our cohort told us that they did not return to work although they wished to. Some practitioners did not allow patients to go back to work for no good reason," Dr. Rudler said.

The authors note that employers, physicians, and government health care programs should adjust their mindset. They write, liver transplant "should not be considered a disease but a surgery that enables former patients to continue with a normal life."

SOURCE: http://bit.ly/1MZakgD

Eur J Gastroenterol Hepatol 2015.