title: Liver transplantation: a success in most casesBut what about the less fortunate patients?
abstract: Liver transplantation offers the chance of a life-saving intervention for many terminal liver patients. At the present time, the survival rate is high and the quality of survival is good. That does not alter the fact that this technology - like so many others - has a number of unintentioned side-effects. Consideration of these side-effects should be included in a careful evaluation of the technology.As part of a broad evaluation of the Dutch Liver Transplant Programme in Groningen answers were sought to the following questions: (1) With what psycho-social problems are transplanted patients confronted? (2) What does it mean for a patient to be rejected for transplantation? (3) What are the experiences of (the next-of-kin of) patients when the technology fails? The research subjects comprised patients as well as their families. The methods used were interviews and questionnaires.From the results it appears that one-third of the transplanted patients had to deal with serious psychological problems. For rejected patients the decision not to operate was a heavy blow. Most of these nevertheless succeeded in re-establishing an acceptable level of well being, provided they survived for some time. According to one-third of the relatives of patients who died following transplantation, the patients' involvement in the programme hampered the acceptance of their loss; feelings of bitterness were common among them.It is concluded that the negative side-effects of liver transplant technology can never be eliminated completely, but that there are several ways to curtail them. Some of these are briefly discussed.
authors.affiliation: University of Groningen, Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Heyink
authors.forename: T
authors.initials: T
authors.lastname: Tymstra