[Psychological and somatic aspects of living liver donors: preoperative assessment and postoperative course].
OBJECTIVE
Living donor liver transplantation (LDLT) has been gaining importance in the treatment of end-stage liver disease in adults as a partial solution to the growing organ shortage. Thus far, only few empirical studies have been published on the situation of donors who are faced with the risk of medical complications after resection of the right hepatic lobe.


METHODS
87 potential donors were preoperatively assessed in the years 2000 and 2001 at the Charité Berlin. 41 potential donors were excluded, 46 donors (31 women, 15 men, mean age 41 [19 - 67] years) underwent liver surgery and were re-assessed 6 months after the operation. The frequency of postoperative complications and the course of psychosocial parameters were investigated. Donors' moods were analysed with the Berlin Mood Questionnaire, the physical complaints were assessed with the Giessen Complaint Questionnaire. The preoperative interviews of 20 potential donors were analysed according the current social qualitative research methods.


RESULTS
In 11 % (n = 10) of potential donors transplantation was not recommended for psychosocial reasons because they showed a marked ambivalence towards the operation. After operation, 22 % (n = 12) of donors had postoperative complications. Most relevant single causes of severe impairment were temporary and reversible biliary leakages from the cutting edge. There were no long- term complications. 26 % (n = 10) of donors showed postoperative high values for anxious depression and physical complaints.


CONCLUSIONS
The resection of the right hepatic lobe holds promise of a good psychosocial outcome for most donors, irrespective of donation-related complications. The psychosocial impairment and physical complaints of some donors after transplantation are yet not clearly understood. Further psychosocial studies will be necessary to develop criteria for an evidence based medical care of living donors.
Walter
M
M
Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité Universitätsmedizin Berlin, Campus Mitte und Campus Virchow-Klinikum, Berlin. marc.walter@upkbs.ch
Pascher
A
A
Papachristou
C
C
Danzer
G
G
Langrehr
M
M
Frommer
J
J
Neuhaus
P
P
Klapp
B F
BF
D000328:Adult; D000339:Affect; D000368:Aged; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000523:psychology; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology; D011300:Preoperative Care; D011795:Surveys and Questionnaires