Anonymous Living Liver Donation: Donor Profiles and Outcomes

Abstract

There are no published series of the assessment process, profiles and outcomes of anonymous, directed or nondirected live liver donation. The outcomes of 29 consecutive potential anonymous liver donors at our center were assessed. We used our standard live liver assessment process, augmented with the following additional acceptance criteria: a logical rationale for donation, a history of social altruism, strong social supports and a willingness to maintain confidentiality of patient information. Seventeen potential donors were rejected and 12 donors were ultimately accepted (six male, six female). All donors were strongly motivated by a desire and sense of responsibility to help others. Four donations were directed toward recipients who undertook media appeals. The donor operations included five left lateral segmentectomies and seven right hepatectomies. The overall donor morbidity was 40% with one patient having a transient Clavien level 3 complication (a pneumothorax). All donors are currently well. None expressed regret about their decision to donate, and all volunteered the opinion that donation had improved their lives. The standard live liver donor assessment process plus our additional requirements appears to provide a robust assessment process for the selection of anonymous live liver donors. Acceptance of anonymous donors enlarges the donor liver pool.

Long-Term Follow-Up After Right Hepatectomy for Adult Living Donation and Attitudes Toward the Procedure

“…37 With a reported donor 3-month perioperative complication rate of 24% 36 and an overall complication rate of 40%, 37 these series provide important observations. Although the long-term follow-up of donors is missing, their preliminary results are encouraging.…”

“…Although the long-term follow-up of donors is missing, their preliminary results are encouraging. 36,37 …”

Predonation psychosocial evaluation of living kidney and liver donor candidates: a systematic literature review

“…Once accepted as a donor, a cooling‐off period or waiting interval (i.e., period between consent and donation) is recommended in nine papers (23.5%), ranging from minimally 1 week to as much time the donor needs , to ensure that the decision to donate has been adequately considered and to allow time to withdraw their consent.…”

Practices for Supporting and Confirming Decision-Making Involved in Kidney and Liver Donation by Related Living Donors in Japan: A Nationwide Survey

“…In a similar context, a number of consensus statements from Europe and the United States (8) have recommended the use of an independent living donor advocate (ILDA) for living organ donors, and this has also been reported in various programs and regional protocols (14)(15)(16)(17)(18)(19)(20)(21)). An ILDA is defined as ''a professional who is not involved in the recipient's care, who advocates the welfare of the potential donor, and ensures safe evaluation and protection of the donor's rights,'' (13) but this role is not necessarily consistent and may vary between programs; for example, it may range from the provision of education, policy monitoring, and donor advocacy to active participation in the evaluation (13).…”