Posttraumatic growth in liver transplant recipients: result of a prospective cohort study

C. Annema, A. Venema, H.J. Metselaar, B. van Hoek, R.J. Porte, A.V. Ranchor

Wednesday 4 march 2020

14:10 - 14:20h at Leo Franssen zaal

Parallel session: Parallel sessie V – Donatie en Verpleegkundige abstracts

Background: A significant number of liver transplant recipients report psychological problems after transplantation. On the other hand, they also report positive psychological changes, often referred to as post-traumatic growth (PTG). PTG is the positive psychological change witnessed as a result of the struggle with a highly challenging life event. Because little is known about PTG in liver transplant recipients, this study aimed to examine: 1) the extent to which PTG occurs, 2) the presence of distinct trajectories of PTG, and 3) demographic, clinical, and personal variables of influence on trajectories of PTG in liver transplant recipients.

Methods: A prospective cohort study among adult liver transplant recipients (n = 104) from three transplant centers in the Netherlands. Data regarding demographic, psychosocial, and personal variables were retrieved by self-report questionnaires before transplantation (T0) and at 3 (T1), 6 (T2), 12 (T3) and 24 (T4) months after transplantation. PTG was assessed by the Post Traumatic Growth Inventory (PTGI). Clinical data were retrieved by medical record review. Stratification was based on 0.5 SD of the difference in PTGI-score between T0 and T1. Kruskal-Wallis tests were used to compare groups.

Results: In the overall sample, the mean PTGI-score increased significantly from 43.0 (± 23.8) at T0 to 50.4 (±24.1) at T1, but did not change significantly afterwards (T2-T4). Based on the difference in score betweenT0-T1 three distinct trajectories of PTG were found: a group with an increase in PTGI-score (51.9%), a group with a stable PTGI-score (27.9%), and a group with a decrease in PTGI-scores (20.2%). Compared to transplant recipients within the trajectories of stable and increased PTGI-score, transplant recipients within the trajectory of decreased PTGI-score were found to be younger (p=.02), lived more often alone (p=.01), were longer hospitalized after the transplant (p=.01), showed higher anxiety (p=.04) and depression (p<.01) scores, a lower score on personal control (p=.03) and had a higher discrepancy between expected and observed quality of life score on all domains on T1 (p<.03).

Conclusions: A subset of transplant recipients experienced PTG after transplantation. Interventions aimed at regaining control may be helpful to enhance PTG in this group.