title: The effect of Liver Transplantation on the quality of life of the recipient's main caregiver - a systematic review.
abstract: Liver transplantation (LT) is a transformative, life-saving procedure with life-long sequale for patients and their caregivers. The impact of LT on the patient's main caregiver can be underestimated. We carried out a systematic review of the impact of LT on the Health-Related Quality of Life (HRQL) of LT patients' main caregivers. We searched 13 medical databases from 1996 to 2015. We included studies with HRQL data on caregivers of patients following LT then quality assessed and narratively synthesized the findings from these studies. Of 7076 initial hits, only five studies fell within the scope of this study. In general, they showed caregiver burden persisted in the early period following LT. One study showed improvements, however, the other four showed caregiver's levels of stress, anxiety and depression, remained similar or got worse post-LT and remained above that of the normal population. It was suggested that HRQL of the patient impacted on the caregiver and vice versa and may be linked to patient outcomes. No data were available investigating which groups were at particular risk of low HRQL following LT or if any interventions could improve this. The current information about LT caregivers' needs and factors that impact on their HRQL are not adequately defined. Large studies are needed to examine the effects of LT on the patients' family and caregivers to understand the importance of caregiver support to maximize outcomes of LT for the patient and their caregivers.
authors.affiliation: Leeds liver unit, St James's University Hospital, Leeds, UK.
authors.forename: Alastair L
authors.initials: AL
authors.lastname: Young
authors.affiliation: Leeds liver unit, St James's University Hospital, Leeds, UK.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Rowe
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Absolom
authors.affiliation: Leeds liver unit, St James's University Hospital, Leeds, UK.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Jones
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Downing
authors.affiliation: Centre for Reviews and Dissemination, University of York, York, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Meader
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Glaser
authors.affiliation: Leeds liver unit, St James's University Hospital, Leeds, UK.
authors.forename: Giles J
authors.initials: GJ
authors.lastname: Toogood
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000453:epidemiology; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D006801:Humans; D016031:Liver Transplantation; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology*
keywords: caregiver; health-related quality of life; liver transplant; outcomes