Psychological Outcomes of Living Liver Donors From a Multicenter Prospective Study: Results From the Adult-to-Adult Living Donor Liver Transplantation Cohort Study2 (A2ALL-2)

Butt, Zeeshan; Dew, Mary Amanda; Liu, Q.; Simpson, Mary Ann; Smith, Abigail R.; Zee, Jarcy; Gillespie, Brenda W.; Abbey, Susan; Ladner, Daniela P.; Weinrieb, Robert M.; Fisher, Robert A.; Hafliger, Silvia; Terrault, Norah A.; Burton, James R.; Sherker, Averell H.; DiMartini, Andrea F.

doi:10.1111/ajt.14134

Cited by 49 publications

(51 citation statements)

References 41 publications

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“…The duration of hospital stay after donor operation was significantly longer and perioperative complications with Clavien classification greater than grade IIIa were more frequent in donors with psychiatric complications than in those without psychiatric complications. In LDLT donors, age and sex, relationship with recipient, ambivalence and motivation to be LDLT donor, feeling for donation, and hospitalization have all also been reported to be associated with psychiatric complications [8,25]. Our observations were consistent with previous reports that suggested that the development of postoperative psychiatric complications was associated with postoperative physical complications [5,6,26,27].…”

Section: Discussionsupporting

confidence: 91%

“…Although LDLT donors with psychiatric complications have been previously reported [1,8,19], little is discussed about long-term outcomes of LDLT donors who required psychiatric treatment. Additionally, there are no reports regarding the effects and outcomes of psychiatric treatment delivered by psychiatrists.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, approximately 1-10% of LDLT donors have been reported to develop psychiatric complications after donor surgery [5][6][7][8][9]. Interestingly, in many existing studies, it is unclear whether psychiatric complications were diagnosed and treated by a psychiatrist [5,6,8]. Moreover, little is discussed about the long-term outcomes of LDLT donors who develop psychiatric complications.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features and Long-Term Outcomes of Living Donors of Liver Transplantation Who Developed Psychiatric Disorders

et al. 2020

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Departmental sources Background: In the field of living donor liver transplantation (LDLT), it is important to ensure donor's psychological well-being. We report on clinical features and long-term outcomes of LDLT donors who developed psychiatric disorders after their donor operations. Additionally, we compare patient backgrounds, as well as surgical and perioperative aspects between LDLT donors with and without postoperative psychiatric complications. Material/Methods: Between November 1998 and March 2018, we identified 254 LDLT donors at our hospital. Among these, we investigated those who had newly developed psychiatric complications and required psychiatric treatment after donor operation. Results: The median duration of follow-up was 4 years. Sixty-five donors were lost to follow-up. Eight donors (3.1%) developed postoperative psychiatric complications, including major depressive disorder in 4, panic disorder in 2, conversion disorder and panic disorder in 1, and adjustment disorder in 1. The median duration from donor surgery to psychiatric diagnosis was 104.5 days (range, 12 to 657 days) and the median treatment duration was 18 months (range, 3 to 168 months). Of those, 3 donors required psychiatric treatment over 10 years, and 4 donors remained under treatment. The duration of hospital stay after donor operation was significantly longer and perioperative complications with Clavien classification greater than grade IIIa were more frequent in donors with psychiatric complications than in those without psychiatric complications (P=0.02 and P=0.006, respectively). Conclusions: Accurate diagnosis and appropriate treatment for psychiatric disorders by psychiatrists and psychologists are important during LDLT donor follow-up. Minimization of physiological complications might be important to prevent postoperative psychiatric complications in LDLT donors.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Features and Long-Term Outcomes of Living Donors of Liver Transplantation Who Developed Psychiatric Disorders

et al. 2020

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“…Ours is one of the largest studies conducted on the psychological outcomes of living donors of low socioeconomic status in the United States. RELIVE, A2ALL, and several other studies indicate that living donors durably enjoy high life satisfaction 1,8,9,11,12,24,37 . This may be related to high self‐esteem, pride, and validation of well‐being through a generous act and external acknowledgment.…”

Section: Discussionmentioning

confidence: 90%

Satisfaction with life and depressive symptoms in living organ donors and non‐donors: New insights from the National Living Donor Assistance Center

Mathur

Hong

Goodrich

et al. 2020

Clinical Transplantation

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we utilized a cross-sectional study design to evaluate short-term depressive symptoms and satisfaction with life in living donors and non-donors (those who were declined or withdrew from evaluation) using the Satisfaction with Life Scale (SWLS) and the PHQ-8, with and without risk adjustment using linear regression.Results: National Living Donor Assistance Center participants originated from 207 US transplant centers. 52% of NLDAC participants responded to the survey (n = 3423; donors = 2848 (58.6% of all donors), non-donors = 575 (33.5% of all nondonors); n centers = 201)). Respondents were significantly older, more likely to be female, white, non-Hispanic, married, more educated, more full-time employed, and more likely to be unrelated to the recipient vs non-respondents (all, P < .001). Among survey respondents, donors were significantly younger, more likely to be non-Hispanic, employed, and related to the recipient compared to non-donors (all, P < .05).Higher PHQ-8 scores were correlated with lower SWL scores (r = −.32, P < .001).Both groups displayed high SWLS (donors vs non-donors: 27.1 vs 26.3, P = .002).Both groups had low levels of depressive symptoms overall, but donors had more symptoms than non-donors (3.5 vs 2.4, P < .001). After risk adjustment, non-donors had significantly less depressive symptoms by PHQ-8 (28% lower, P < .001), but had lower life satisfaction (1.2 points lower, P < .001). Conclusions: Donors and non-donors have high global levels of overall life satis-faction and low levels of depressive symptoms at 8 weeks after donation or denial.While small effect sizes were observed between groups in these outcomes, being a non-donor was an independent risk factor for lower life satisfaction, which warrants further evaluation.

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“…Those donors who do not have enough time to make a decision may show depression symptoms [23]. On the other hand the survival of the recipient play an active role on donor's unwillingness to donate again [24]. According to DuBay, et al [25] researchers should pay more attention to the donors who have been diagnosed with psychiatric disorders or who are young or have had further education.…”

Section: Resultsmentioning

confidence: 99%

Quality of Life and Anxiety Status following Donor Liver Transplantation

Saraçoğlu¹,

Bulutcu²,

Oklu³

et al. 2018

Int J Anesthetic Anesthesiol

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Study objective: Anxiety disorder, which is encountered in surgical patients receiving general anesthesia is a psychological and physical condition, characterized by sudden onset of hazard perception and extensive fear, and may lead to panic disorder. In this study, we aimed to determine anxiety levels of liver transplantation donors via a questionnaire and reveal their quality of life and anxiety status during the 1 st postoperative day and month. Design: Prospective observational study. Setting: In the critical care. Patients: Following the Ethics Committee approval, forty subjects of both sexes, between the ages of 18 and 75 years, who were on the list of liver transplant donors were included in the study. Interventions: A 10-item anxiety and quality of life questionnaire was prepared using scales applied to surgical patients, such as the Amsterdam Preoperative Anxiety and Information Scale for preoperative anxiety, the Spielburger State-Trait Anxiety and Inventory and the Profile of Mood States on the 1st postoperative day and month. Measurements: Data regarding the donor's age, sex, marital status, educational background, history of previous surgeries, the degree of affinity between donor and the recipient, number and age of their children, and duration of patient's disease were recorded. Main results: On the first day and in the first month, the total score on questions "I am worried about anesthesia" was significantly lower than the total scores on the questions "I am worried about the success of the surgical procedure" and "I am worried about the risk of anesthesia-related mortality" (p = 0.007 and p = 0.001, respectively). Conclusions: Many living donors are motivated to make their decision on this procedure in a short time. We believe that allocating more time to informing patients and donors and holding information meetings on anesthesia and surgical procedures at intervals may be beneficial.

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Psychological Outcomes of Living Liver Donors From a Multicenter Prospective Study: Results From the Adult-to-Adult Living Donor Liver Transplantation Cohort Study2 (A2ALL-2)

Cited by 49 publications

References 41 publications

Clinical Features and Long-Term Outcomes of Living Donors of Liver Transplantation Who Developed Psychiatric Disorders

Clinical Features and Long-Term Outcomes of Living Donors of Liver Transplantation Who Developed Psychiatric Disorders

Satisfaction with life and depressive symptoms in living organ donors and non‐donors: New insights from the National Living Donor Assistance Center

Quality of Life and Anxiety Status following Donor Liver Transplantation

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