Tremor, Daily Functioning, and Health-Related Quality of Life in Solid Organ Transplant Recipients

Transpl Int. 2023 Mar 16:36:10951. doi: 10.3389/ti.2023.10951. eCollection 2023.

Abstract

Solid organ transplant recipients (SOTR) frequently report tremor. Data concerning tremor-related impairment and its potential impact on health-related quality of life (HRQoL) are lacking. This cross-sectional study assesses impact of tremor on activities of daily living and HRQoL using validated questionnaires among SOTR enrolled in the TransplantLines Biobank and Cohort Study. We included 689 SOTR (38.5% female, mean [±SD] age 58 [±14] years) at median [interquartile range] 3 [1-9] years after transplantation, of which 287 (41.7%) reported mild or severe tremor. In multinomial logistic regression analyses, whole blood tacrolimus trough concentration was an independent determinant of mild tremor (OR per µg/L increase: 1.11, 95% CI: 1.02 to 1.21, p = 0.019). Furthermore, in linear regression analyses, severe tremor was strongly and independently associated with lower physical and mental HRQoL (β = -16.10, 95% CI: -22.23 to -9.98, p < 0.001 and β = -12.68, 95% CI: -18.23 to -7.14, p < 0.001 resp.). SOTR frequently report tremor-related impairment of activities of daily living. Tacrolimus trough concentrations appeared as a main determinant of tremor among SOTR. The strong and independent association of tremor-related impairment with lower HRQoL warrants further studies into the effects of tacrolimus on tremor. Clinical Trial Registration: ClinicalTrials.gov, Identifier NCT03272841.

Keywords: ADL impairment; calcineurin inhibitors; health-related quality of life; solid organ transplant recipient; tremor.

Publication types

  • Clinical Trial

MeSH terms

  • Activities of Daily Living
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Organ Transplantation*
  • Quality of Life
  • Tacrolimus
  • Transplant Recipients
  • Tremor

Substances

  • Tacrolimus

Associated data

  • ClinicalTrials.gov/NCT03272841

Grants and funding

The authors declare that the TransplantLines Biobank and Cohort study received funding from Astellas BV (TransplantLines Biobank and Cohort study), Chiesi Pharmaceuticals BV (PA-SP/PRJ-2020-9136), and co-financed by the Dutch Ministry of Economic Affairs and Climate Policy by means of the PPP-allowance made available by the Top Sector Life Sciences & Health to stimulate public-private partnerships. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. Some authors are funded by unrestricted grants: VM was supported by a VENI research grant by the Dutch Research Council (NWO; grant #09150161810030), a research grant from the Dutch Ministry of Economic Affairs (Health∼Holland Public Private Partnership grant #PPP-2019-024), and a research grant from the Dutch Society for Gastroenterology (NVGE #01-2021); AS was supported by a Mandema Stipend received from the Junior Scientific Masterclass Groningen (MS-2018). ME was supported by a Mandema Stipend received from the Junior Scientific Masterclass Groningen (MS-2021).