October 1992

Severity of Hepatic Encephalopathy Before Liver Transplantation Is Associated With Quality of Life After Transplantation

Author Affiliations

From the Departments of Psychiatry (Drs Tarter, Switala, Plail, and Havrilla) and Surgery (Dr Van Thiel), University of Pittsburgh (Pa).

Arch Intern Med. 1992;152(10):2097-2101. doi:10.1001/archinte.1992.00400220111019

Background.—  Cirrhosis is associated with a chronic low-grade hepatic encephalopathy and disturbances in quality of life. This study investigated the extent to which severity of hepatic encephalopathy before orthotopic liver transplantation correlated with quality of life.

Methods.—  A battery of neuropsychological tests was administered to nonalcoholic patients to quantify severity of hepatic encephalopathy. The Sickness Impact Profile was administered before and after surgery to document quality of life across multiple health and psychosocial dimensions.

Results.—  There was substantial improvement from the pretransplant to the posttransplant periods across almost all dimensions of quality of life. Neuropsychological test scores explained up to 20% of the variance in magnitude of change from pre (before) to post (after) surgery.

Conclusion.—  Severity of hepatic encephalopathy (particularly with respect to static ataxia and fine motor control) is associated with posttransplantation improvement in quality of life.(Arch Intern Med. 1992;152:2097-2101)