Preoperative expectations and postoperative quality of life in liver transplant survivors

Objective: To assess normalization in the lives of Liver transplant patients and the impact of preoperative expectations on postoperative quality of life (QOL). Design: A semistructured interview, 2 QOL questionnaires, and chart reviews of medical histories. Setting: Internal medicine department at Innsbruck university hospital, Austria, Participants: Fifty-five patients (32 men, 23 women) with liver transplants. Interventions: The Sickness Impact Profile (SIP) and Functional Assessment of Cancer Therapy-General. Results: Patients' preoperative expectations of a normal Life style posttransplantation were predominantly optimistic (60%), but postoperatively only 40% thought that their expectations had been realized. The patients' SIP values showed significant impairments in nearly every area of life when compared with the values of a healthy control group. Only "complications during the hospitalized phase" had a statistically significant impact among the sociodemographic and clinical parameters on postoperative QOL. The lowest QOL scores were found among patients whose expectations of a return to normal life style had not been realized. Conclusion: Unmet life-style expectations after liver transplantation may lead to increased stress, which affects QOL long term. This finding is of clinical relevance; therapeutic measures, particularly professional pretransplant counseling, are indicated.