Aims and Objectives: The purpose of this study was to examine the intensity, interference, duration, and prevalence of fatigue in liver transplant recipients and to explore the influencing factors of post-transplantation fatigue.

Background: Fatigue is a highly prevalent symptom experienced by patients who underwent the liver transplantation. However, the influencing factors of fatigue are poorly understood. More studies are needed to document fatigue and its influencing factors in patients after liver transplantation. Design A cross-sectional design was used in this study.

Methods: A convenience sample of liver transplant recipients was recruited at an outpatient liver transplant clinic in Beijing, China. Self-report survey data were provided by liver transplant recipients using the Fatigue Symptom Inventory (FSI), the Hospital Anxiety and Depression Scale (HADS), the Perceived Social Support Scale (PSSS), and the Athens Insomnia Scale (AIS). Demographic, clinical, psychosocial parameters were evaluated as influencing factors of fatigue.

Results: Participants (n=285) included 69 women and 216 men. Fatigue was found in 87.02% of liver transplant recipients. Mean scores of fatigue intensity items were 4.47±2.85, 1.93±1.97, 3.15±2.13, 2.73±2.42 (most fatigue, least fatigue, average fatigue, fatigue now). Mean score of fatigue interference were 2.27±2.09. Number of days having fatigue in the previous week was 2.26±2.02 and the mean percentage of fatigue time each day was 2.75±2.44. Spearman Correlation Analysis showed that fatigue intensity was associated with anxiety, depression, and insomnia (P<0.001 for all), while fatigue interference was associated with gender, anxiety, depression, and insomnia (P<0.05 for all). In the multiple linear regression analysis, anxiety and insomnia were associated with fatigue intensity (P<0.001), and insomnia, depression and anxiety were associated with fatigue interference (P<0.001).

Conclusions: Fatigue is common and pervasive in liver transplant recipients, and it is strongly associated with insomnia, anxiety, and depression.

Relevance to Clinical Practice: Health professionals need to pay attention to fatigue in liver transplant recipients and take appropriate measures to reduce patients’ fatigue.