**5.4 Autoimmune and Cholostatic Liver Diseases**

Liver transplant is a well established therapy for patients with autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). The perceived QOL in patients with cholestatic liver disease before and after LT was measured using some aspects of QOL, including symptoms (pruritus, fatigue); physical, social, and emotional functioning; health perceptions (stigma); and overall QOL (Gross, 1999). Changes in these QOL parameters before and after LT were studied and also the relationships between clinical and QOL factors and was demonstrated that cholestatic liver disease displayed the best cost-effectiveness ratio after LT (Longworth, 2003). Following transplantation QOL was substantially better than before transplantation and there were no differences in QOL parameters between patients with AIH, PBC and PSC. Some authors have pointed out that a patient's QOL 1 year after transplant could not be predicted by pre-transplantation QOL variables (Krasnoff, 2005; Bownik, 2009).

### **5.5 Acute Liver Disease**

Acute liver failure continues to be associated with a high mortality rate, and emergency liver transplantation is often the only life-saving treatment (Riordan& Williams, 2003). Although, the short-term outcomes are worse in comparison with those for non-urgent cases, due to the initial recovery process, the majority of patients transplanted with acute liver failure, reported that they have a good quality of life (Sargent, 2007; Dobbels, 2010). The keys to long-term success and continued progress in urgent liver transplantation are the use of good-quality whole grafts and a short waiting list time, both of which depend on access to a sufficient pool of organ donors. In this group the pre-transplantation HRQOL data could not be assessed due to patients' clinical situation. However, there have been studies published reporting an acceptable survival and QOL., in the short or medium term (Chan, 2009).
