Abstract
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 post-operatively 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 posttransplant,
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.
