title: Influence of acute cellular rejection and depressive symptomatology on liver transplant recipients' quality of life.
abstract: BACKGROUND
  The objective of this study was to analyze the influence of two variables (acute cellular rejection and depressive symptomatology) on liver transplant recipients' quality of life.
  
  
  METHODS
  Using a 2 × 2 factorial design, two groups were selected: 44 patients who had acute cellular rejection and 44 patients without this medical complication. After an average of 6 years since the transplant, patients were assessed with the Hospital Anxiety and Depression Scale and the SF-36 Health Survey. Analysis of variance, t test for unpaired samples, and Cohen's d effect size index were applied.
  
  
  RESULTS
  The presence of clinical depressive symptomatology negatively affected all dimensions of quality of life (P < .001; large effect sizes); and interactive effects between factors acute cellular rejection and depressive symptomatology were found in the dimensions role-physical (P = .049) and bodily pain (P = .017). Transplant recipients with clinical depressive symptomatology scored lower on both dimensions (role-physical, P = .110, d = 0.52, medium effect size; bodily pain, P = .001, d = 1.25, large effect size) if they had an acute cellular rejection. In contrast, if they did not exceed the clinical threshold for depressive symptomatology, there were no differences in these dimensions (role-physical, P = .239, d = -0.33, small effect size; bodily pain, P = .555, d = 0.16, null effect size) between transplant recipients with and without acute cellular rejection.
  
  
  CONCLUSIONS
  Clinical depressive symptomatology is associated with poorer quality of life in liver transplant recipients; and the long-term differences in the dimensions role-physical and bodily pain between liver transplant recipients with and without acute cellular rejection depend on patients' mental health.
authors: Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatment, University of Seville, Spain. Electronic address: anperez@us.es.
authors: M A
authors: MA
authors: Pérez-San-Gregorio
authors: Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatment, University of Seville, Spain.
authors: A
authors: A
authors: Martín-Rodríguez
authors: Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatment, University of Seville, Spain.
authors: E
authors: E
authors: Fernández-Jiménez
authors: Critical Care and Urgencies, University Hospital Virgen del Rocío of Seville, Spain.
authors: J
authors: J
authors: Pérez-Bernal
authors: Hepatic-Biliary-Pancreatic Surgery and Liver Transplant Unit, University Hospital Virgen del Rocío of Seville, Spain.
authors: M A
authors: MA
authors: Gómez-Bravo
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006084:Graft Rejection / Q000523:psychology*; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires; D066027:Transplant Recipients / Q000523:psychology*