Quality of life before and after liver transplantation: experiences with 7 patients with primary biliary cirrhosis in a 2-year follow-up

  • A. Lähteenmäki
  • K. Höckerstedt
  • S. Kajaste
  • M. Huttunen
Conference paper


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.

Key words

Liver transplantation Quality of life 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Adams DH, Gunson B, Honigsberger L, et al (1987) Neurological complications following liver transplantation. Lancet I: 949–951CrossRefGoogle Scholar
  2. 2.
    Christopherson LK (1986) Quality of life; organ transplantation and artificial organs. Intl J Techn Assist Health Care 2:553–562CrossRefGoogle Scholar
  3. 3.
    Derogatis LR (1983) SCL-90. Clinical Psychometric Research, MD, ThomsonGoogle Scholar
  4. 4.
    Heyink J, Tymstra T, Slooff MJH, et al (1989) Liver transplanta-tion-psychosocial problems following the operation. Transplantation 49:1018–1019CrossRefGoogle Scholar
  5. 5.
    Höckerstedt K, Kajaste S, Isoniemi H, et al (1990) Tests for encephalopathy before and after liver transplantation. Transplant Proc 22:1576–1578PubMedGoogle Scholar
  6. 6.
    Küchler T, Kober B, Brölsch C, et al (1991) Quality of life after liver transplantation: can a psychosocial support program contribute? Transplant Proc 23:1541–1544PubMedGoogle Scholar
  7. 7.
    Kuchler T, Kober B, Broelsch C, et al (1991) Quality of life after liver transplantation. Clin Transplant 5:94–101Google Scholar
  8. 8.
    Lezak MD (1983) In: Neuropsychological assessment, 2nd edn. Oxford University Press, New YorkGoogle Scholar
  9. 9.
    Markus BH, Dickson ER, Grambsch PM, et al (1989) Efficacy of liver transplantation in patients with primary biliary cirrhosis. N Engl J Med 320:1709–1713PubMedCrossRefGoogle Scholar
  10. 10.
    Surman OS (1989) Psychiatric aspects of organ transplantation. Am J Psychiatry 146:972–982PubMedGoogle Scholar
  11. 11.
    Surman OS, Dienstag JL, Cosimi AB, et al (1987) Psychosomatic aspects of liver transplantation. Psychother Psychosom 48: 26–39PubMedCrossRefGoogle Scholar
  12. 12.
    Tarter RE; Switala J, Arria A, et al (1990) Subclinical hepatic encephalopathy. Transplantation 50:632–637PubMedCrossRefGoogle Scholar
  13. 13.
    Trzepacz PT, Brenner R, Thiel DH, Van (1989) A psychiatric study of 247 liver transplantation candidates. Psychosomatics 30: 147–153PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • A. Lähteenmäki
    • 1
  • K. Höckerstedt
    • 2
  • S. Kajaste
    • 2
  • M. Huttunen
    • 1
  1. 1.Department of PsychiatryHelsinki University HospitalHelsinkiFinland
  2. 2.Fourth Department of SurgeryHelsinki University HospitalHelsinkiFinland

Personalised recommendations