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Quality of Life and Technology Assessment (1989) / Chapter Skim
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3. Quality-of-Life Measures in Liver Transplantation
Pages 45-50

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From page 45...
... For example, venous bypass procedures that lower excessive venous pressure decrease the incidence of bleeding and the amount of ascites, but Hey may exacerbate hepadc encephalopathy and increase He risk of cooing disorders. When successful, liver transplantation alleviates virtually all of He complications of end-stage liver disease, but it has its own set of effects on a patient's physical well-being and life-style.
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From page 46...
... Because patients with end-stage liver disease often have serious costive impairments, it is not always possible to use patient-directed, subjective assessment tools. QUALITY-OF-LIFE MEASURES A computer-based literature search encompassing medical jounces from 1966 to He present, caped MEDDLE, produced 13 articles that dealt explicitly win quality-of-life assessment of patients who had survived liver transplantation.
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From page 47...
... These measures included return to work or school, number of days spent in the hospice, exercise tolerance, and financial status. Presence of Psychopathology In a descnption of detailed pomransplant psychiatric interviews win patients who were wed enough bow before and after the transplant to sustain a two to two and one-half hour interview, House et al.
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From page 48...
... CONCLUSIONS A major difficulty in evaluating Me effect of liver transplantation on Me quality of life of padents suffering from end-stage liver disease is me inability of many pre~ansplant patients to complete evaluations that could then be compared with pos~nsplantation scores. Such profound ~mpa~rments of mental capacity in end-stage liver disease mean Mat a large percentage of transplantation candidates cannot be evaluated by standard quality-of-life measures that rely solely on subjective patient responses.
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From page 49...
... In these circumstances we must rely more heavily on clinical testing or on ratings assumed to be proxies for quality of life. Third, when the liver disease is not sufficiently advanced to produce serious mental impairment, there is substantial evidence that several selfand family-reported quality-of-life measures win show improvement over He pretransplant state, but quality of life may not return to the level He patient enjoyed prior to the development of liver disease.
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From page 50...
... Tartar, R.E., Hegedus, A.M., Gavaler, I.S.~., Schade, R.R., Van Thiel, D.H., and Stanza, T.E. Acute effects of liver transplantation on neuropsychological capacity as determined by studies performed pretransplantation and four to six weeks following surgery.
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Key Terms

  • liver disease
  • liver transplant
  • prior social
  • social situation
  • produce serious

  • transplant candidates
  • six months
  • six weeks
  • transplant patients
  • days spent

  • following liver
  • neurophysiologic tests
  • life following
  • consensus development
  • detrimental impact

  • exhibited increased
  • detailed pomransplant
  • dally living
  • patient enjoyed
  • alleviates virtually

  • social position
  • decreased liver
  • financial status
  • development statement
  • prospective study

  • pretransplant state
  • search encompassing
  • transplant padents
  • neurophysiological data
  • serious malnutrition


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