Assessment of the Quality of Life in Patients After Liver Transplantation as an Important Part of Treatment Results

Self-Esteem Related to Quality of Life in Patients Over 60 Years Old Who Received an Orthotopic Liver Transplantation More Than 10 Years Ago

BACKGROUND

Orthotopic liver transplantation (OLT) represents an improvement in the quality of life (QoL) in the short to medium term. However, there is little information about QoL in the long-term post-transplant and its relation with psychological variables such as self-esteem.

OBJECTIVE

To analyze the perceived QoL in relation to the level of self-esteem in patients over 60 years of age who received an OLT more than 10 years ago.

MATERIALS AND METHODS

Cross-sectional descriptive study. Including patients from the Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA).

INSTRUMENT

to evaluate the QoL: EuroQol-5D questionnaire; to evaluate health status: 1. social transfer index and 2. visual analog scale (VAS); to measure self-esteem level: Rosenberg scale. Sociodemographic and clinical variables. Nonparametric analysis (P < .05).

RESULTS

Analyzed 46 patients, 70% men (n = 32) and 30% women (n = 14); mean age of 70.85 ± 6.7 years and mean years of post-OLT survival of 15.91 ± 5.3 years. Average score in QoL: 0.8 ± 0.17 in the social transfer index and 77.07 ± 16.82 in the VAS. Average level of self-esteem: 34 ± 3.55 point. When analyzing the variables, there are no differences in age or post-OLT years. There are significant differences according to sex (P = .001). However, the diagnosis influences the patient's perception of QoL (P < .001). The post-OLT survival correlates negatively with social transfer index (P = .017) and self-esteem level (P = .045). In addition, those patients living in the city presented a higher level of self-esteem (P = .03).

CONCLUSION

Sex, diagnosis, post-OLT years, social environment, and place of residence have an influence on the QoL and self-esteem of patients.

The Perception of Medical Students at King Abdulaziz University Hospital Regarding the Liver Transplant Allocation System

Background: The benefit of liver transplantation is not only to increase the patient’s lifetime but also for persistent relief of pain and anxiety. Shortage of the organ is the main hindrance of transplantation around the world, leading authorities to pass a general law for the reasonable distribution of organs and come up with the Model for End-Stage Liver Disease (MELD) system which scores the severity of liver disease and risk of mortality in order to detect the mechanism of allocation. 

Objective: This study aims to assess medical students’ perception of the liver transplant and allocation system.

Methods: A cross-sectional survey was carried out among 402 medical students at King Abdulaziz University in Jeddah, Saudi Arabia.

Results: The majority of the medical students (84.4%) believed that a successful liver transplant improves both lifetime and quality of life. Most of the students also saw that the minimum survival rate should be five years after transplantation and that the patient should recover to be at least ambulatory, even if restricted by strenuous physical activity. When asked whether urgency or prospect of success defined a successful transplant, most of the students who chose urgency were preclinical (50.7%), while the prospect of success was the dominant answer chosen by students in their clinical years of study (66.1%).

Conclusion: The criteria determining the success of a liver transplant include a gain in both lifetime and quality of life. The majority of respondents wanted the capacity to benefit to be considered in the liver allocation system.