A longitudinal investigation of the psychological and cognitive sequelae of liver transplantation

• Main Author: Gooday, Rebecca M.
• Published: University of Edinburgh 1997
• Subjects: 616.89
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.651593

The psychological impact of chronic liver disease is vast, including the psychiatric and psychosocial consequences of chronic illness, and the cognitive deficits experienced due to hepatic encephalopathy. Orthotopic liver transplantation is now the treatment of choice for end-stage, chronic liver disease, and it is now recognised that psychological factors play an important role in the evaluation of its outcome, as well as the more traditional measures of morbidity and mortality. Successful liver transplant recipients face a lifetime of drug regimens as well as the common psychological difficulties associated with transplantation, including fear of rejection and preoccupation with the donor. Preliminary findings have suggested that liver transplant recipients experience enhanced quality of life postoperatively compared to pre-transplant levels, although not at the level experienced by the general population. Investigation of the neuropsychological functioning of recipients has also produced mixed, although generally positive results. Much of the research in this field has, however, been methodologically flawed with the use of non-standardised measures, lack of control groups and retrospective, cross-sectional designs. Using a prospective design the present study aimed to investigate the effects of liver transplantation on neuropsychological functioning, psychiatric status and quality of life. Subjects were assessed pre-transplant and approximately three years post-transplant, as were a group of patients with liver disease not considered for transplantation and healthy controls. The roles of social support and self-esteem were investigated. The results were analysed and discussed. Limitations of the present study and implications for future research were identified.