Abstract
Background:Liver transplantation is the optimal method of treatment in patients with end-stage liver failure. Transplantation medicine has significantly progressed in the last time, but some psychology and psychosomatic problems still remain unsolved. Health-Related Quality of Life (HRQL) in liver transplant is considered a useful measure of evolutionary process of the illness. Objective:The authors analyzed the evolution of HRQL in pre-transplant (waiting-list patients) and post-transplant (first year after liver transplant) periods of liver transplant Spanish patients. Methods:A prospective and longitudinal study was carried out among patients who received a liver transplant from a deceased donor. They were assessed in four phases: at the time of inclusion on the transplant waiting-list, and 3, 6, and 12 months after receiving the graft. We used a structured interview and SF-36 and Euroqol-5D (EQ-5D) Health Questionnaires. Results:The greater differences were found between pre-transplant and post-transplant stages with less well-being in the stage before the transplant. No significantly differences were observed when comparing the 3, 6 and 12 months from post-transplant stage. Conclusion:The HQRL of liver patients improved after the transplant, being appreciated a tendency to the stabilization from three months onwards. We suggest that the psychological intervention, in liver patients, should be conducted in waiting-list patients and in the first 3 months post-transplant, periods with a poor mental health (anxiety, depression, and stress by fear to the unknown thing) and a low adhesion to the treatment that can generate a smaller graft and/or patient survival.
Highlights
Liver transplant has evolved from experimental treatment to standard treatment for all patients with progressive and irreversible hepatobiliary disease
The greater differences were found between pre-transplant and post-transplant stages with less well-being in the stage before the transplant
The HQRL of liver patients improved after the transplant, being appreciated a tendency to the stabilization from three months onwards
Summary
Liver transplant has evolved from experimental treatment to standard treatment for all patients with progressive and irreversible hepatobiliary disease Their success has been measured by patient and graft survival, this kind of interventions can lead to very diverse conditions, ranging from recovery of "near” normality to a condition of characteristics that are similar to chronicity, with a broad array of deficits and impairments [1]. Some time after transplant surgery, all of this leads patients to become more concerned about their quality of life than their longevity [3] In this context, HealthRelated Quality of Life (HRQL) becomes more relevant; it is a multidimensional construct that includes three essential domains (physical, psychological, and social functioning), which may be affected by the disease and/or by treatment [46]. Health-Related Quality of Life (HRQL) in liver transplant is considered a useful measure of evolutionary process of the illness
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