[Patients' subjective experiences after liver transplantation]

To study prospectively a cohort of patients in the first year after liver transplantation (LTx) with respect to their subjective experiences and their clinical condition.

Sixteen non-selected, consecutive patients (9 male) of the Clinic of Visceral Surgery of Cologne University were interviewed between 4 and 12 months after orthotopic LTx by narrative interviews. The interviews were audiotaped and transcribed according to standard international rules. We analysed the content of the interviews according to Grounded Theory and performed an ideal type analysis based on case comparison.

Nine patients (56.25 %) had a mental disorder according to ICD-10. Patients' subjective experiences of the transplantation could be grouped into five ideal types: the successful, the grateful, the help-seeking, the vulnerable, and the special patient. These ideal types were found to be of a dimensional pattern when re-assessed at single-case level, i. e. individual patients fulfilled criteria of these ideal types to different degrees.

Our patients perceive LTx predominantly as successful therapy for terminal liver disease. They use different coping strategies to come to terms with the considerable impact of transplantation. Each strategy implies specific risk profiles which have to be kept in mind when dealing clinically with LTx patients.