Right hepatic lobe donation for living donor liver transplantation: impact on donor quality of life.
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.
Trotter
J F
JF
Division of Gastroenterology/Hepatology, University of Colorado Health Sciences Center, Denver, CO 80262, USA. james.trotter@uchsc.edu
Talamantes
M
M
McClure
M
M
Wachs
M
M
Bak
T
T
Trouillot
T
T
Kugelmas
M
M
Everson
G T
GT
Kam
I
I
D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000191:economics / Q000379:methods* / Q000523:psychology; D019520:Living Donors / Q000523:psychology; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D011584:Psychology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement / Q000191:economics