Meta-analysis of Anxiety and Depression in Liver Transplant Patients Before and After Transplantation

Abstract

Background

Liver transplantation is a life-saving intervention for patients with end-stage liver disease, but it also presents significant psychological challenges that can affect patient outcomes. These challenges include managing preoperative expectations, postoperative expectations, adjusting to postoperative changes, and addressing long-term health concerns, all of which contribute to high levels of anxiety and depression in this patient group. This study aims to explore the prevalence and changes in anxiety and depression among liver transplant patients before and after transplantation through a comprehensive meta-analysis.

Methods

The data extracted for the article included the number of episodes of depression and anxiety, the total number of liver transplant patients, the mean and standard deviation of the Hospital Anxiety and Depression (HADS) scale before and after liver transplantation, and the mean and standard deviation of the SF-36 Quality of Life Assessment Scale, A search was conducted in the PubMed, Web of Science, Embase, and Cochrane databases were searched up to October 3, 2023, All previous articles were reviewed, and the results were analyzed using Stata.14 software.

Results

In this meta-analysis, the study found that the incidence of pre-transplant anxiety was 52% (95 CI%: 0.38, 0.66), and the incidence of depression was 47% (95 CI%: 0.34, 0.60), after transplantation, the patient's anxiety and depression were improved to some extent, the incidence of anxiety before transplantation was 52% (95 CI%: 0.38, 0.66), and the incidence of anxiety after transplantation was 3% (95 CI%: -0.05, 0.12). The incidence of depression before transplantation was 65% (95 CI%: 0.56, 0.73), and the incidence of anxiety after transplantation was 42% (95 CI%: 0.38, 0.46). In addition, the study found that patients' anxiety and depression were significantly improved with the extension of time after transplantation. Furthermore, the study revealed that patients' anxiety and depression significantly improved with the passage of time after transplantation. Anxiety levels were measured as [WMD 6.55 (95% CI: 3.68, 9.42)] within 3 months, [WMD 5.44 (95% CI: -0.84, 11.93)] after 3 months, and improved further after 3 months, with a WMD of [3.48 (95% CI: 0.88, 7.84)]. Additionally, the anxiety level at 3 months showed a WMD of [8.47 (95% CI: 2.79, 14.14)]. Finally, the study evaluated the patients' quality of life and health and found significant improvement after transplantation. The score on the SF-36 Quality of Life Assessment Scale increased by [WMD 18.44 (95% CI: 14.08, 22.80)].

Conclusion

Dynamic psychological assessment of patients before and within 3 months after liver transplantation is meaningful and may improve patient outcomes from the perspective of caring for patients' psychological problems.