Introduction: Outcomes after liver transplantation are most commonly reported by medical professionals as rates of graft failure, episodes of acute rejection, length of hospital stay, re-hospitalizations, and patient survival. Important outcomes as defined by patients have yet to be explored.

Methods: A convenience sample of pre-transplant listed patients in outpatient hepatology clinics and members of a post-transplant support group were approached for face-to-face audio-recorded interviews using an interview guide with internal prompts. Transcribed interviews were analyzed using qualitative content analysis between independent coders to identify and characterize post-transplant expected outcomes for patients.

Results: Five post-transplant and ten pre-transplant patients were interviewed. Ten interviewees were male (67%) and five were female (33%). Interviewees ranged in age from 45-69. Diagnoses ranged from alcohol cirrhosis (33%), hepatitis C cirrhosis (27%), non-alcoholic steatohepatitis (13%), hepatocellular carcinoma (13%), primary sclerosing cholangitis (13%), and hepatitis B cirrhosis (7%). Themes of expected outcomes that arose from patients included adequate energy, functional independence, developing new medical conditions, avoiding re-transplantation, and longer duration of life. Length of hospital stay, need for critical care, and undergoing additional invasive procedures were not considered important by patients.

Conclusion: Several patient-identified outcomes after liver transplantation are currently collected, reported, and included in the informed consent process, while others are not. Patient statements indicate that there may be a meaningful discrepancy between patient and provider expectations for the transplant process. Prioritizing patient-centered outcomes could improve the quality of shared decision-making pre-transplantation and the accuracy of patient expectations for post-transplant conditions.

CITATION INFORMATION: Lee G., Obayemi J., Rubin E. Patient-Centered Outcomes after Liver Transplantation: A Qualitative Study Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress