Guidelines for the psychosomatic evaluation of living liver donors

Erim, Yeşim; Malagó, M; Valentin‐Gamazo, Camino; Senf, Wolfgang; Broelsch, C. E.

doi:10.1016/s0041-1345(03)00159-3

Cited by 24 publications

(24 citation statements)

References 5 publications

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“…Another question is to what extent patients understand the information provided and if they are aware of the risks and benefits of the procedure. In this sense, the role of the psychiatrist is essential, evaluating the “competence of the donors to make a decision” and finding out whether this decision was made voluntarily or whether it was influenced by any kind of internal or external coercion 25, 26…”

Section: Discussionmentioning

confidence: 99%

Experience after the evaluation of 700 potential donors for living donor liver transplantation in a single center

et al. 2004

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Adequate selection of donors is a major prerequisite for living donor liver transplantation (LDLT). Few centers report on the entire number of potential donors considered or rejected for living donation. From April 1998 to July 2003, a total of 111 living donor liver transplantations were performed at our institution, with 622 potential donors for 297 adult recipients and 78 potential donors for 52 pediatric recipients evaluated. In the adult group, only 89 (14%) potential donors were considered suitable, with a total of 533 (86%) potential donors rejected. Of these, 67% were excluded either at initial screening or during the first and second steps of the evaluation procedure. In 31% of all cases, the evaluation of donors was canceled because of recipient issues. In the pediatric group, 22 (28%) donors were selected, with the other 56 (72%) rejected. Costs of the complete evaluation process accounted for 4,589 Euro (€) per donor. The evaluation of a potential living donor is a complex and expensive process. We present the results on the evaluation of the largest group of potential donors for adults reported in the literature. Only 14% of potential donors in our series were considered suitable candidates. It has not yet been established who should cover the expenses of the evaluation of all rejected donors. In conclusion, all efforts should be made in order to develop an effective screening protocol for the evaluation of donors with the aim of saving time and resources for a liver transplantation program.

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Section: Discussionmentioning

confidence: 99%

Experience after the evaluation of 700 potential donors for living donor liver transplantation in a single center

et al. 2004

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“…Similarly, our group has provided important guidelines for psychosomatic evaluation of potential donors for adult LDLT [49]. Our psychosomatic evaluation consists of following relevant aspects: (i) psychological stability of the potential donor and (ii) verification of informed consent (iii) competence to consent and (iv) absence of coercion.…”

Section: Donor Evaluationmentioning

confidence: 99%

Current trends in live liver donation

et al. 2007

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Summary The introduction of living donor liver transplantation (LDLT) has been one of the most remarkable steps in the field of liver transplantation (LT), able to significantly expand the scarce donor pool in countries in which the growing demands of organs are not met by the shortage of available cadaveric grafts. Although the benefits of this procedure are enormous, the physical and psychological sacrifice of the donors is immense, and the expectations for a good outcome for themselves, as well as for the recipients, are high. We report a current overview of the latest trends in live liver donation in its different aspects (i.e. donor's selection, evaluation, operation, morbidity, mortality, ethics and psychology). This review is based on our center's personal experience with almost 200 LDLTs and a detailed analysis of the international literature of the last 7 years about this topic. Knowing in detail how to approach to the different aspects of living liver donation may be helpful in further improve donor's safety and even recipient's outcome.

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“…These residual feelings must be distinguished from what, in contrast, can be termed acute ambivalence, i.e., feelings of indecision so marked that it is determined in the psychosocial evaluation that the prospective donor is unable to give adequate informed consent to proceed. 7,10,11,95 Residual ambivalence, instead, pertains to feelings that remain shortly before donation, despite the fact that the donor intends to proceed with donation. While acute ambivalence, resulting in a rule-out of the individual as a donor, is uncommon (<2% of rule-outs), 96–99 some degree of residual ambivalence before donation has been noted in up to 75% of donors.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Poor Psychosocial Outcomes in Living Organ Donors: From Description to Theory-Driven Intervention Development and Initial Feasibility Testing

et al. 2012

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Context Although some living donors experience psychological, somatic, and interpersonal difficulties postdonation, interventions to prevent such outcomes have not been developed or evaluated. Objective To (a) summarize empirical evidence on postdonation psychosocial outcomes, (b) describe a theoretical framework to guide development of an intervention to prevent poor outcomes and (c) describe development and initial evaluation of feasibility and acceptability of the intervention. Methods Based on a narrative literature review suggesting that individuals ambivalent about donation are at risk for poor postdonation psychosocial outcomes, the intervention targeted this risk factor. Intervention structure and content drew on motivational interviewing principles in order to assist prospective donors to resolve ambivalence. Data were collected on donor characteristics at our institution to determine whether they constituted a representative population in which to evaluate the intervention. Study participants were then recruited to assess intervention feasibility and acceptability. They were required to have scores > 0 on the Simmons Ambivalence Scale (indicating at least some ambivalence about donation). Results Our population was similar to the national living donor population on most demographic and donation-related characteristics. Eight individuals approved to donate either a kidney or liver segment were enrolled for intervention pilot testing. All successfully completed the 2-session telephone-based intervention before scheduled donation surgery. Participant ratings of acceptability and satisfaction were high. Open-ended comments indicated that the intervention addressed participants’ thoughts and concerns about the decision to donate. Conclusions The intervention is feasible, acceptable, and appears relevant to donor concerns. A clinical trial to evaluate intervention efficacy is warranted.

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Guidelines for the psychosomatic evaluation of living liver donors

Cited by 24 publications

References 5 publications

Experience after the evaluation of 700 potential donors for living donor liver transplantation in a single center

Experience after the evaluation of 700 potential donors for living donor liver transplantation in a single center

Current trends in live liver donation

Prevention of Poor Psychosocial Outcomes in Living Organ Donors: From Description to Theory-Driven Intervention Development and Initial Feasibility Testing

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