# Assessing health-related quality of life in patients with interstitial lung diseases with and without lung transplantation using the GR-Scale

## TL;DR

This study uses the GR-Scale to assess quality of life in patients with lung diseases, both with and without lung transplants, finding that transplants improve quality of life and that complications like CLAD worsen it.

## Contribution

The GR-Scale is applied for the first time in lung transplant recipients with interstitial lung diseases to assess HRQoL longitudinally.

## Key findings

- Lung transplant recipients had better HRQoL than non-transplanted patients at baseline and follow-up.
- Transplanted patients with CLAD had significantly worse HRQoL than those without CLAD.
- Physical symptoms showed more pronounced differences in HRQoL than psychological symptoms.

## Abstract

Lung transplantation (LTx) aims to improve the health-related quality of life (HRQoL). We applied the GR-Scale for the first time in patients after LTx due to interstitial lung diseases (ILDs), compared it longitudinally with non-transplanted patients, and evaluated the impact of chronic allograft dysfunction (CLAD) on the HRQoL.

In this prospective longitudinal cohort pilot study, we compared HRQoL by utilizing the GR-Scale between non-transplanted patients (n = 32) and transplanted patients (n = 26). In a second step, we compared HRQoL between transplanted patients with (n = 11) and without CLAD (n = 42). A follow-up assessment was conducted after 3 to 6 months.

Statistically significant differences in HRQoL were observed between patients after LTx and non-transplanted patients, with worse HRQoL in non-transplanted patients, at both baseline (p < 0.001) and follow up (p < 0.001). Furthermore, the GR-Scale found statistically significant worse HRQoL in transplanted patients with CLAD compared to those without, both at baseline (p = 0.014) and follow-up (p = 0.011). Additionally, significant differences were found in the individual items of the GR-Scale, with physical symptoms showing a more pronounced difference than psychological symptoms in both analyses. No significant differences were observed between the groups regarding age and sex.

Our pilot study suggests that the GR-Scale is an easy-to-use and valuable tool to assess HRQoL in lung transplant recipients providing important additional information for clinical evaluation of this patient population, also longitudinally.

Our study was retrospectively registered in the German Clinical Trial Register (DRKS) on 02.11.2022 (DRKS-ID: DRKS00030599).