当院成人肝移植における就労状況の検討

抄録

【Objective】 Advances in liver transplantation (LT) have shifted treatment goals from merely saving lives to improving post-transplant quality of life (QOL). Return to work is one of the key indicators of social reintegration and QOL after transplantation. This study aimed to evaluate the employment status of adult liver transplant recipients before and after transplantation at a single institution.

【Methods】 Adult patients who underwent either living-donor or deceased-donor LT at our institution between 1997 and 2023 were included. A self-administered questionnaire was used to assess employment status, employment type, and barriers to returning to work during the five years before and after LT. The study was approved by the institutional ethics committee (approval number: 022-0285).

【Results】 A total of 117 out of 126 eligible patients responded (response rate: 92.9%). The median age at the time of LT was 52.7 years (range: 19.2-70.0). Employment rates decreased gradually before LT (from 72.6% three years prior to 65.0% one year prior) and increased steadily after LT (from 46.2% at one year post-LT to 65.7% at five years post-LT). Patients who were employed one year before LT (n = 76) had significantly higher employment rates five years after LT (89.1%) compared to those who were unemployed at that time (n = 20, 44.4%). Of those who returned to work, 48.8% resumed employment at their pre-transplant workplace, and 47.9% were employed full-time. The main barriers to re-employment included physical limitations and insufficient understanding or support in the workplace.

【Conclusion】 The employment rate five years after LT (65.7%) was comparable to that of the general population in Japan. Pre-transplant employment status was significantly associated with post-transplant work outcomes. Tailored support by transplant coordinators, considering individual physical conditions, workplace environments, and employer support may promote successful return-to-work among LT recipients.