Quality of life in Spanish patients with liver transplant

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 posttransplant 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.