Advances in liver transplantation
Donation: Donor evaluation
Importance of Awareness of Perioperative Social and Physical Situations of Living Donors for Liver Transplantation

https://doi.org/10.1016/j.transproceed.2012.01.049Get rights and content

Abstract

Introduction

Transplantation in Japan still depends on living donors even after the new revised law. We must pay attention to protect living donors.

Patients and Methods

Perioperative qualities of life after living donation for liver transplantation were assessed with questionnaires including the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF36-v2). Nonparametric Mann-Whitney tests were used to determine statistical significance. P values <.05 were considered significant.

Results

Thirty-one among 33 donors answered questionnaires (93.9%). The 15 men and 16 women of average age of 39.7 years had a median hospital stay of 16 days and median duration after surgery of 78 months. Ten of 33 (35.7%) donors considered themselves to be the only possibility. The decision to a donor was established prior to informed consent in 23 donors (74.1%). Six months were required for them to experience a full recovery after donor surgery. Hamilton depression/anxiety score was significantly increased among donors who considered themselves to be the only possibility or those who had decided prior to informed consent. SF36-v2 revealed a significant decrease in social functioning among donors who did not have sufficient time to decide before surgery. General health was significantly decreased among donors who required more than 6 months for full recovery. Perioperative management of pain influenced general health, physical role, bodily pain, and physical functioning.

Conclusion

We must pay attention to depression and anxiety among living donors. More care should be focused on pain control and sharing of information of postoperative courses.

Section snippets

Patient and Methods

Perioperative qualities of life after living donation for liver transplantation were assessed with questionnaires including the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF36-v2).3, 4 Preoperative psychological assessment was done by a psychiatrist, who analyzed Hamilton's depression and anxiety scores. Nonparametric Mann-Whitney tests were used to determine statistical significance with P values <.05 considered to be significant.

Results

The 31 among 33 living donors who answered questionnaires (93.9%) included 15 males and 16 females of average age of 39.7 years (Table 1). Median hospital stay was 16 days. Median duration after donor surgery was 78 months. Ten of 33 (35.7%) donors considered themselves to be the only donor. The decision to be a donor was made prior to informed consent in 23 donors (74.1%). Six months was needed for them to experience full recovery after donor surgery. The Hamilton depression/anxiety score

Discussion

Living donors are widely accepted for liver transplantation. However, donor hepatectomy is not always safe not only for physical status but also for mental health. A study from a high-volume hepatobiliary center reported an 47.3% overall morbidity rate among right lobe donations, which did not significantly improve with time. Also, some disfiguring complications, which were graded as minor, may have significantly impacted donor QOL.5 Moreover, the estimated donor death rate has been reported to

References (13)

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