Toward a patient-centered approach to the well-being of patients with chronic liver disease or liver transplantation

Abstract

Quality of life (QoL) is a multidimensional construct that assesses physical status, emotional well-being, social functioning, and the ability to carry out daily activities. Its measurement facilitates shared decision-making, prioritization of multidisciplinary interventions, and the evaluation of outcomes that go beyond biochemical metrics or disease severity. The factors influencing QoL in cirrhosis depend on the degree of liver impairment (compensated vs. decompensated cirrhosis) and on the presence of ascites, encephalopathy, jaundice, or variceal bleeding, as well as comorbidities or symptoms such as sarcopenia/malnutrition, diabetes, hypotension, obesity, kidney disease, fatigue, pain, insomnia, pruritus, and abdominal discomfort. In the sphere of mental health and social support, anxiety, depression, and the strength of family and financial support networks are key determinants. Adverse effects of treatments, adherence, and changes in diet and lifestyle also play a role. Socioeconomic and cultural factors such as access to care, health education, treatment adherence, and the ability to follow care plans are equally important.