Critical Appraisal of Liver Transplant Studies

¶ … Yang, Shan, Saxena and Morris (2014) provide a review of liver transplantation in their study for Liver International. The researchers are from Melbourne Medical School and the Department of Surgery in South Eastern Sydney, Australia. The article is entitled "Liver transplantation: a systematic review of long-term quality of life." It focuses on how liver transplants are the only way to cure terminal liver disease because no other intervention works. The study explores the quality of life of patients who receive this treatment by examining the QOL of transplant survivors of "5 or more years" post-surgery. The study's method is a literature review and what it finds is that quality of life of patients post-surgery is far better than those who do not undergo the operation. Complications aside (and these are often predicted to be worse than they actually are), the findings suggest that recovery is typically reasonable and side effects such as employment of the patient are fine for about 5 years post-operation but that they do decline after these 5 years are up (this of course may be impacted by the age of the patient as well and may be incidental to the study's focus). Physical activity is not necessarily limited and depends upon the success of the transplant.

The study concludes by asserting that liver transplants do allow patients to experience a quality of life after operation, but that the QOL has specific limitations with attendant functionality positives. Nonetheless, functionality and limitations are far better in this respect than prior to the operation for the patient, because without transplant there is literally no hope for any quality of life for the patient because of the terminality of the liver. Thus, liver transplantation is viewed here is a positive and in fact best (and only) option for a patient who wants any degree of quality of life in the future. The QOL may not be perfect but it is reasonable given the conditions of the patient's health.

The results of the study are valid, as the study is mainly a literature review of other studies performed in the past and a collection of their findings. This is not an RCT trial study, as it is just a literature review, and the literature was collected using key words searches on specific criteria associated with the subject. The study does include a detailed description of how the literature was found, and qualitative analysis using the Cochrane guidelines were utilized in order to assess the legitimacy of the literature's findings, as well as PRISMA guidelines (Yang, Shan, Saxena, Morris, 2014, p. 1299). Thus validity of the individual studies is assessed according to this approach.

The results of the study were consistent across studies with "heterogeneous data precluding meta-analysis" and the (p. 1300) and aggregate data used for the overall study. The results indicated the QOL over the various 23-study scope analysis did not vary in so far as relation to pre-operation status of patients was concerned, though different studies did focus on varying degrees and aspects of QOL status. There was no intervention or treatment effect conducted in this study, but in those of the literature reviewed, the consensus was that QOL signified that intervention was generally more beneficial than no intervention.