A longitudinal study of 20 liver transplant recipients was conducted to investigate their posttransplant recovery experience. Data were collected using semistructured interviews at 6 weeks, 6 months, and 1 year after transplantation. Qualitative analysis of data revealed physical, psychological, social, economic, and spiritual dimensions of recovery. Findings reflect ongoing improvement of physical health and functionality for most recipients. Those with continuing health problems often suffered from preexisting health conditions. Psychological adjustment was uneven, with intermittent periods of fear, anxiety, and depression. Some recipients reported short-lived split identities and personality changes. Social support of family was critical in the hospital and at home. Economic issues became primary by the 1-year interview, with all recipients questioning whether they could afford ongoing healthcare and medicines. Spiritual needs were met in secular and nonsecular activities. Findings suggest that healthcare personnel should attend to the lived experience of liver transplant recipients.
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References
1.
KlassenACKlassenDKBrookmeyerRFrankRGMarconiK. Factors influencing waiting time and successful receipt of cadaver liver transplant in the United States: 1990 to 1992. Med Care.1998;36:281–294.
2.
OtteJB. History of pediatric liver transplantation. Where are we coming from? Where are we going?Pediatr Transplant.2002;6:378–387.
3.
BelleSHBeringerKCMurphyJB. Liver transplantation in the United States: 1988 to 1990. Clin Transplant.1991;5:13–29.
4.
StarzlTENorikoMAbu-ElmagdK. Tolerogenic immunosuppression for organ transplantation. Lancet.2003;361:1502–1510.
5.
MatthewsJBRamosEBluestoneJA. Clinical trials of transplant tolerance: Slow but steady progress. Am J Transplant.2003;3:794–804.
6.
RodesJNavasaM. Liver transplantation and quality of life. Can J Gastroenterol.2000;14:693–699.
7.
Shokouh-AmiriMHGrewalHPVeraSR. Eighteen years of experience with adult and pediatric liver transplantation at the University of Tennessee, Memphis. Clin Transplant.2000;14:255–261.
8.
CooperDKSamaraENMielesL. Survival following organ transplantation in an Oklahoma Institution, 1985–1993. J Okla State Med Assoc.1994;87:506–508.
9.
ZettermanRKBelleSHHoofnagleJH. Age and liver transplantation: A report of the liver transplantation database. Transplantation.1998;66:500–506.
10.
EckhoffDEMcGuireBMYoungC. Liver transplantation in the era of cost constraints. South Med J.2000;93:392–396.
11.
PayneJLMcCartyKRDougasJG. Outcomes analysis for 50 liver transplant recipients: The Vanderbilt experience. Am J Surg.1996;62:320–325.
12.
WallWJDuffJHGhentCNStillerCRKeownPAKuttJL. Liver transplantation: The initial experience of a Canadian centre. Can J Surg.1985;28:286–289.
13.
GillTMFeinsteinAR. A critical appraisal of the quality of quality-of-life measurements. JAMA.1994;272:619–626.
14.
BryanSRatcliffeJNeubergerJMBurroughsAKGunsonBKBuxtonMJ. Health-related quality of life following liver transplantation. Qual Life Res.1998;7:115–120.
15.
DewMASwitzerGEGoycooleaJMAllenASDiMartiniAFKormosRLGriffithBP. Does transplantation produce quality of life benefits? A quantiative analysis of the literature. Transplantation.1997;64:1261–1273.
16.
DewMASwitzerGEDimartiniAFMatukaitisJFitzgeraldMGKormosRL. Psychosocial assessments and outcomes in organ transplantation. Prog Transplant.2000;10:239–261.
17.
PinsonCWFeurerIDPayneJLWisePEShockleySSperoffT. Health-related quality of life after different types of solid organ transplantation. Ann Surg.2000;232:597–607.
18.
YounossiZMMcCormickMPriceLL. Impact of liver transplantation on health-related quality of life. Liver Transplant.2000;6:779–783.
19.
ForsbergALorenzonUNilssonFBackmanL. Pain and health-related quality of life after heart, kidney, and liver transplantation. Clin Transplant.1999;13:453–460.
20.
LeyendeckerBBartholomewUNeuhausR. Quality of life of liver transplant recipients. Transplantation.1993;56:561–567.
21.
DraperP. Quality of life as quality of being: An alternative to the subject-object dichotomy. J Adv Nurs.1992;27:965–970.
22.
LoBiondo-WoodGWilliamsLWoodRPShawBW. Impact of liver transplantation on quality of life: A longitudinal perspective. Appl Nurs Res. February 1997;10:7–32.
23.
HowardD. The impact of waiting time on liver transplant outcomes. Health Serv Res.2000;35:1117–1134.
24.
ZieniewiczKSkwarekANyckowskiP. Comparison of the results of liver transplantation for elective versus urgent indications. Transplant Proc.2003;35:2262–2264.
25.
VintroAQ. The continuity of nutrition care through liver transplantation. Nutr Clin Care.2001;4(1):17–33.
26.
BucuvalasJCRychmanFC. Long-term outcome after liver transplantation in children. Pediatr Transplant.2002;6:30–36.
27.
CommanderMNeubergerJDeanC. Psychiatric and social consequences of liver transplantation. Transplantation.1992;53:1038–1040.
28.
KoberBKuchlerTBroelschCKremerBHenne-BrunsD. A psychological support concept and quality of life research in liver transplantation program: An interdisciplinary multicenter study. Psychother Psychosom.1990;54:117–131.
29.
AbbeySBoydellKPitchLStewartD. The lived experience of women with liver transplants. Clin Invest Med.1997;20:S107.
30.
ForsbergABackmanLMollerAForsbergA. Experiencing liver transplantation: A phenomenological approach. J Adv Nurs.2000;32:327–334.
31.
JohnsonCDHathawayDK. The lived experience of end-stage liver failure and liver transplantation. J Transplant Coord.1996;6:130–133.
32.
ThomasDJ. The lived experience of people with liver transplants. J Transplant Coord.1995:5:65–71.
33.
WainwrightSP. Recovery from liver transplantation: A literature review. J Adv Nurs.1994;20:861–869.
34.
WainwrightSP. The transformational experience of liver transplantation. J Adv Nurs.1995;22:1068–1076.
35.
HicksFDLarsonJLFerransCE. Quality of life after liver transplant. Res Nurs Health.1992;15:111–119.
36.
PadillaGVMishelHHGrantMM. Uncertainty, appraisal and quality of life. Qual Life Res.1992;1:155–165.
37.
RobertsonG. Individuals' perception of their quality of life following a liver transplant: An exploratory study. J Adv Nurs.1999;30:497–503.
38.
NairSEustaceJThuluvathPJ. Effect of race on outcome of orthotopic liver transplantation: A cohort study. Lancet.2002;359:287–293.
39.
RubinABabbieE. Research Methods for Social Work.Belmont, Calif: Wadsworth Publishing Co; 1997.
40.
SimmonsRAbressL. Quality of life issues for end-stage renal disease patients. Am J Kid Dis.1990;15:201–208.
41.
DunneKSullivanK. Family experiences of palliative care in the acute hospital setting. Int J Palliat Nurs.2000;6:170–174.
42.
StarzomskiRHiltonA. Patient and family adjustment to kidney transplantation with and without an interim period of dialysis. Nephrol Nurs J. February 2000;27:17–18, 21–33.
43.
ThomasDJ. Returning to work after liver transplant: Experiencing the roadblocks. J Transplant Coord.1996;6:134–138.
44.
DewMARothLHSwitzerGE. Gender differences in patterns of emotional distress following heart transplantation. J Clin Psychol Med Sett.1996;3:367–386.
45.
EvangelistaLSDoeringLDracupK. Meaning and life purpose: The perspectives of post-transplant women. Heart Lung.2003;32:250–257.
46.
UbelPA. Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Qual Life Res.2003;12:599–607.
