The role of preoperative psychosocial counselling on the improvement of the recipient compliance and speed of recovery after liver transplantation – A systematic review of the literature and expert panel recommendations

Abstract

Background: Psychosocial disorders ranging from anxiety to severe psychiatric diseases and active alcohol/substance abuse are frequent in liver transplant candidates and potentially associated with worse post-transplant outcomes. Therefore, psychosocial evaluation is mandatory to optimize success after liver transplantation. However, how to carry out this evaluation, the type of intervention needed and its potential impact on patient outcome remain unclear.Objectives: To investigate whether psychosocial assessment may help in predicting risks of poor outcome; and to investigate whether psychosocial interventions may mitigate these risks and improve posttransplant outcomes, in particular compliance and speed of recovery.Data sources: Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.Methods: Systematic review following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel. The protocol

Liver Transplantation in Patients with Alcohol-Associated Liver Disease: Current Strategies and Future Perspectives

“…The link between alcohol abuse and poverty, discrimination, disadvantage and increased rates of psychological distress and are well known [46]. Alcohol related issues are best supported by a specialist team and the literature suggests specialized professionals embedded within the transplant team are the most effective in reducing post-transplant alcohol relapse and mortality [47,48].…”

“…Not adequate social assistance, ethanol/substance addiction and psychiatric problems may need heterogeneous strategies. Moreover, several patients can have multiple psychosocial problems that necessitate a coordinated pluridisciplinary approach [46].…”

Enhanced recovery after surgery for liver transplantation: a review of recent literature

“…The role of preoperative psychosocial counseling on the improvement of recipient compliance and speed of recovery after liver transplantation --a systematic review of the literature and expert panel recommendations (Weiss et al [13])…”

“…Depression and anxiety are frequently observed in liver transplant patients along with concomitant substance abuse and poor social support. In the systematic review published in 2022, Weiss et al investigated whether psychosocial assessment could identify patients at greater risk for adverse posttransplant outcomes and whether such assessment could positively affect outcomes, specifically compliance and speed of recovery [13]. Fifteen studies were analyzed (5 observational comparative and 10 observational noncomparative) and outcomes included morbidity, mortality, compliance, stress, pain and abstinence.…”