AbstractBackground: Liver transplantation remains the definitive treatment for end-stage liver disease and is also indicated in certain metabolic disorders, like hereditary amyloidosis. Psychiatric comorbidities are commonly observed in transplant recipients, highlighting the need for increased clinical attention to their identification and management.
Case Presentation: We report the first documented case of a 35-year-old woman with Borderline Personality Disorder who exhibited significant psychiatric deterioration following liver transplantation. The patient presented with emotional instability, suicidality and disrupted interpersonal functioning, which became more pronounced after transplant. Her psychosocial history included childhood sexual trauma and emotional neglect.
Conclusion: This case illustrates how coexisting somatic illnesses can aggravate psychiatric symptoms in vulnerable individuals through both physiological and psychological mechanisms. Literature suggests that depression and anxiety are common post-transplant and are associated with poorer outcomes. Non-pharmacological approaches such as dialectical behavior therapy and trauma-focused psychotherapy are preferred in complex medical contexts like amyloidosis. A multidisciplinary and individualized psychiatric approach is essential in managing transplant recipients with personality disorders to improve long-term outcomes.
