Quality of life before and after liver transplantation: experiences with 7 patients with primary biliary cirrhosis in a 2-year follow-up.
Seven patients with end-stage primary biliary cirrhosis were evaluated both before and 1 and 2 years after liver transplantation using a clinical psychiatric interview and the self-rating questionaire SCL-90. Neuropsychological tests were done before and 1 year after operation. Preoperatively, all patients had a poor general condition and overall quality of life. Flattening of emotions and reactions, regression, disturbances of verbal memory and cognitive function, and dependence on close relatives were observed. One year after transplantation, 6 patients had a much better overall quality of life, and with five patients it improved still further during the 2nd year, but only 2 patients felt that their life situation had fully stabilised. However, nearly all of them experienced phases of moderate or even severe depression or anxiety during those 2 years. On neuropsychological tests patients appeared to be near their normal level. The only patient who died during this follow-up (some months after transplantation) had in her life history a prominent sense of insecurity and mistrust. It seems to take more than a year for the majority of patients to give up the regressive mode of experience and turn to adult interests in life again, as well as psychologically experience the new liver as part of oneself.
Lähteenmäki
A
A
Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland.
Höckerstedt
K
K
Kajaste
S
S
Huttunen
M
M
D000328:Adult; D003071:Cognition; D004644:Emotions; D005190:Family; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008105:Liver Cirrhosis, Biliary / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D016031:Liver Transplantation / Q000502:physiology* / Q000523:psychology*; D008568:Memory; D009483:Neuropsychological Tests; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors