Post-transplant psychosocial and mental health care of the liver recipient

Abstract

Liver transplantation can improve survival and restore quality of life for patients with end-stage liver disease, but recipients can face challenges with mental health issues following transplantation. Substance use disorders are common among liver transplant patients, and clinicians need to be aware of these issues and plan for long-term post-transplant clinical care. Depression is of particular importance being associated with poorer posttransplant outcomes. If psychotropic pharmacologic management is considered, issues with liver recovery, especially during the early postoperative period, need to be evaluated. Patients experiencing cognitive impairment prior to transplant may have ongoing cognitive issues following transplant. Even symptoms associated with hepatic encephalopathy may require a longer period to resolve following transplant. As nonadherence continues to be associated with poorer survival and graft loss, clinicians should be aware of and monitor recipient's adherence to lifelong transplant recommendations, specifically consistent immunosuppressive medication taking. Future interventions targeting addictions, cognitive recovery, and improved adherence are needed.