Psychological strain in urgent indications for living donor liver transplantation

Erim, Yeşim; Beckmann, Mingo; Kroencke, Sylvia; Valentin‐Gamazo, Camino; Malagó, Massimo; Bröering, Dieter C.; Rogiers, Xavier; Frilling, Andrea; Broelsch, Christoph E.; Schulz, Karl‐Heinz

doi:10.1002/lt.21168

Cited by 58 publications

(63 citation statements)

References 35 publications

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“…Unfortunately, few studies have conducted a standardized assessment of donor health-related quality of life (HRQOL) postdonation and the majority have relied on small sample sizes (9). Existing studies suggest that liver donors enjoy a similar, if not better HRQOL compared with the general population, and that the vast majority of donors would go through the process again (10)(11)(12)(13)(14).…”

Section: The Living Donor Partial Hepatectomy Provides No Physical Bementioning

confidence: 99%

Adult Right-Lobe Living Liver Donors: Quality of Life, Attitudes and Predictors of Donor Outcomes

DuBay

Holtzman

Adcock

et al. 2009

American Journal of Transplantation

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To refine selection criteria for adult living liver donors and improve donor quality of care, risk factors for poor postdonation health-related quality of life (HRQOL) must be identified. This cross-sectional study examined donors who underwent a right hepatectomy at the University of Toronto between 2000 and 2007 (n = 143), and investigated predictors of (1) physical and mental health postdonation, as well as (2) willingness to participate in the donor process again. Participants completed a standardized HRQOL measure (SF-36) and measures of the pre-and postdonation process. Donor scores on the SF-36 physical and mental health indices were equivalent to, or greater than, population norms. Greater predonation concerns, a psychiatric diagnosis and a graduate degree were associated with lower mental health postdonation whereas older donors reported better mental health. The majority of donors (80%) stated they would donate again but those who perceived that their recipient engaged in risky health behaviors were more hesitant. Prospective donors with risk factors for lower postdonation satisfaction and mental health may require more extensive predonation counseling and postdonation psychosocial follow-up. Risk factors identified in this study should be prospectively evaluated in future research. participate (n = 204). Procedures used by our center to determine donor suitability for right hepatectomy have been reported elsewhere (1). Eleven donors who had been either lost to follow-up (n = 9) or who informed our program that they were doing well and no longer required follow-up (n = 2) were not contacted. Study designThis is a cross-sectional study in which donors who were at least 3 months postdonation were mailed a package of materials that contained a cover letter explaining the study objectives, a consent form and a written questionnaire. Only those measures that were analyzed in this report will be described here. Postdonation questionnaireLiving liver donors completed a one-time comprehensive questionnaire assessing demographics (sex, age, marital status, ethnicity, education, income and employment

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Section: The Living Donor Partial Hepatectomy Provides No Physical Bementioning

confidence: 99%

Adult Right-Lobe Living Liver Donors: Quality of Life, Attitudes and Predictors of Donor Outcomes

DuBay

Holtzman

Adcock

et al. 2009

American Journal of Transplantation

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“…Donors had more postoperative pain, particularly somatoform pain, and decreased vitality. Three months after LDLT, donor mental quality of life, depression, and anxiety scores were again normal, although they were somewhat linked to recipient outcomes (Erim et al, 2007). The US Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) group reported that 4.1% of all donors (392) had experienced one or more psychiatric complication.…”

Section: Living Donor Liver Transplantation (Ldlt)mentioning

confidence: 99%

Role of Liver Transplantation in Acute Liver Failure

Liou

Larson

2008

Semin Liver Dis

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“…However, living liver donors (LLD) undergo a major surgical operation with no medical benefit for themselves. The procedure is not only physically demanding on LLD (1, 2) but can also involve psychological burden (3, 4). For this reason, LLD are typically chosen to be healthy adults, both physically and emotionally (5).…”

Section: Introductionmentioning

confidence: 99%

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

Dew

Liu

et al. 2017

American Journal of Transplantation

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While single-center and cross-sectional studies have suggested modest impact of liver donation on donor psychological well-being, few studies have assessed these outcomes prospectively among a large cohort. We conducted one of the largest, prospective, multi-center studies of psychological outcomes in living liver donors within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL-2) Consortium. 271 (91%) of 297 eligible donors were interviewed at least once at pre-donation, 3-, 6-, 12- and 24-months post-donation using validated measures. We found that living liver donors reported low rates of major depressive (0–3%), alcohol abuse (2–5%), and anxiety syndromes (2–3%) at any given assessment in their first two years after donation. Between 4.7–9.6% of donors reported impaired mental well-being at various time points. We identified significant predictors for donors’ perceptions of being better people and experiencing psychological growth following donation, including age, gender, relationship to recipient, ambivalence and motivation regarding donation, and feeling that donation will make life more worthwhile. Our results highlight the need for close psychosocial monitoring for those donors whose recipients died (n=27), some of whom experienced guilt and concerns of responsibility. Careful screening and targeted, data-driven follow-up holds promise for optimizing psychological outcomes following this procedure for potentially vulnerable donors.

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Psychological strain in urgent indications for living donor liver transplantation

Cited by 58 publications

References 35 publications

Adult Right-Lobe Living Liver Donors: Quality of Life, Attitudes and Predictors of Donor Outcomes

Adult Right-Lobe Living Liver Donors: Quality of Life, Attitudes and Predictors of Donor Outcomes

Role of Liver Transplantation in Acute Liver Failure

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)

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