Right hepatic lobe donation for living donor liver transplantation: Impact on donor quality of life

Abstract

Adult right hepatic lobe living donor liver transplantation (LDLT) has rapidly gained widespread acceptance as an effective procedure for selected patients with end-stage liver disease. However, there are currently no published data on the effect of this procedure on the quality of life of donors. We report the results of a survey of our living liver transplant donors to determine the effect of right hepatic lobe donation on quality of life. We have performed 30 LDLTs since 1997; 24 of these have a follow-up of 4 months or longer. In August 2000, these patients were sent a questionnaire (including a Medical Outcomes Study 36-Item Short-Form Survey) regarding psychosocial outcomes and symptoms after surgery. Major complications occurred in 4 of 24 patients (16%), and minor complications, in 4 of 24 patients (16%). Complete recovery occurred in 75% of patients at a mean time of 3.4 months. Ninety-six percent of patients returned to the same predonation job after a mean time of 2.4 months, and 66% of patients required a period of light-duty work for a mean of 2.8 months before returning to full-duty work. A change in body image was reported in 42% of patients, and 71% reported mild ongoing symptoms (primarily abdominal discomfort) that they related to the donor surgery for which 29% sought evaluation by a physician. The donor's relationship with the recipient was the same or better in 96% of donors, and the relationship with the donor's significant other was the same or better in 88% of donors. Mean out-of-pocket expenses incurred by donors were $3,660. Sixty-three percent of donors reported experiencing more pain than anticipated. All patients would donate again if necessary, and 96% benefited from the donor experience. In conclusion, (1) all our donors are alive and well after donation; (2) almost all donors were able to return to predonation employment status within a few months; (3) most donors have mild persistent abdominal symptoms, and some donors had a change in body image that they attribute to the donor surgery; and (4) this information should be provided to potential donors so they may better understand the impact of donor surgery. (Liver Transpl 2001;7:485-493.)

Donor quality of life before and after adult-to-adult right liver live donor liver transplantation

“…As shown by the previous studies, [23][24][25] being a preselected group, donors were universally healthier than the population norm. Even in the case when HRQL had not returned to the predonation levels, the scores were still better than the population norm.…”

“…19 In ALDLT, with few exceptions, 20,21 published donor HRQL studies are retrospective and not longitudinal. [22][23][24][25][26] The aim of this study was to prospectively and longitudinally quantify HRQL issues of live liver donors in ALDLT. Attempts were also made to identify donors who were negatively affected and the risk factors accounting for such outcomes.…”

The Quality of Life of Living Liver Fragment Donors

“…Beavers проводилось ис-следование КЖ доноров правой доли печени Trotter и соавт. [42] при помощи опросника SF-36. В ис-следование вошли 24 донора правой доли печени в период с 1997-го по 2000 год.…”

Transplantation hépatique chez l’adulte

“…Globalement, les résultats pour le receveur sont comparables à ceux de la transplantation par donneur en état de mort cérébrale. Toutefois, il s'agit d'une intervention chirurgicale lourde pour le donneur, avec un taux de complications sévères de l'ordre de 15% à 20% [8]. Par analogie avec la transplantation par donneur vivant, la technique du foie partagé (ou split) consiste à séparer le foie d'un donneur cadavérique en deux parties autonomes [9].…”