Mental health and quality of life in liver transplant and cirrhotic patients with various etiologies

Abstract

In this study we aimed to: 1) examine whether there were differences in mental health and quality of life of liver transplant recipients according to etiology that led to transplantation (alcoholic cirrhosis, Hepatitis B/C Virus, hepatocellular carcinoma and others); and 2) to compare mental health and quality of life between liver transplant and cirrhotic patients, according to etiologies that most often lead to liver transplantation (alcoholic and Hepatitis C Virus). Two patient groups participated: 168 transplant recipients and 63 cirrhotic patients. Mental health was assessed by the Hospital Anxiety and Depression Scale and quality of life by the SF-36 Health Survey. We found the following results: 1) statistically significant differences were found in anxiety, depression, general health, and vitality; in all of them, transplant patients due to Hepatitis C Virus showed the highest impairment and transplant patients due to alcoholic cirrhosis showed the lowest deterioration; 2) cirrhotic patients, compared to transplanted, and patients with Hepatitis C Virus, compared to alcoholic liver patients, were the groups with greater biopsychosocial impairment. In the absence of interactive effects between factors groups and etiology, Hepatitis C Virus patients had higher biopsychosocial impairment than alcoholic liver patients, regardless of whether or not they underwent transplant.

En este estudio se plantea: 1) analizar diferencias en salud mental y calidad de vida entre trasplantados hepáticos en función de la etiología desencadenante del trasplante (etílica, Virus de la Hepatitis B/C, hepatocarcinoma y otras), y 2) comparar la salud mental y la calidad de vida entre trasplantados hepáticos y enfermos cirróticos en función de las etiologías que con más frecuencia desencadenan el trasplante hepático (etílica y Virus de la Hepatitis C). Se seleccionaron dos grupos: 168 trasplantados y 63 cirróticos. Se empleó la Escala Hospitalaria de Ansiedad y Depresión y el Cuestionario de Salud SF-36. Los resultaron indicaron: 1) diferencias significativas en las variables ansiedad, depresión, salud general y vitalidad; en todas ellas el mayor deterioro correspondió a trasplantados con el Virus de la Hepatitis C y el menor a etílicos, 2) enfermos cirróticos versus trasplantados hepáticos, y enfermos con el Virus de la Hepatitis C versus etílicos, fueron los grupos con mayor deterioro biopsicosocial. Ante la inexistencia de efectos interactivos entre los factores grupo y etiología, se concluye que los pacientes con Virus de la Hepatitis C presentan mayor deterioro biopsicosocial en comparación con pacientes etílicos, independientemente de que hubieran sido o no trasplantados.