Beyond the mean

Cynthia R. Gross

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

In summary, there is compelling evidence that despite gains in health status, most liver transplant recipients do not have the health-related QOL of similarly aged adults in the general population. It is premature to accept that reduced health is inevitable because of deficits from liver disease experienced before OLT or the burden of immunosuppressive medications. Deficits are not across the board, and interventions to improve outcomes need to carefully target subgroups. It has been shown that, at least in selected transplant recipient series, high mental and physical QOL are possible. Earlier transplantation has been proposed to enable patients to avoid more severe deconditioning and complications, and interventions to improve fitness and reduce unwanted weight gain are being investigated with liver transplant recipients. Post-OLT therapies, particularly steroid therapy, are associated with symptoms and problems ranging from osteoporosis and weigth gain to cancer. Many of these problems are generic to solid-organ transplantation, and interventions developed and tested for kidney, heart, or lung transplant recipients hold promise for liver transplant recipients, as well. Practice interventions to enhance self-care and vocational adaptation, improve adherence, and relieve symptom distress for both patients and caregivers after transplantation are being investigated with solid-organ transplant recipients. Consideration also should be given to testing mind-body-based complementary therapies. These therapies are uniquely well suited to treat symptoms in which additional pharmacological therapies pose unwanted drug interaction risks. In our group, we are currently pilot testing an intervention of yoga and meditation to reduce stress-related symptoms and chronic pain after kidney transplantation. Descriptive QOL articles need to report findings in a manner directly applicable to the needs of clinical trialists so that promising, timely, and cost-effective interventions can be developed and tested to enable all liver transplant recipients to achieve optimal QOL outcomes.

Original languageEnglish (US)
Pages (from-to)260-262
Number of pages3
JournalLiver Transplantation
Volume8
Issue number3
DOIs
StatePublished - 2002

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