title: Psychosocial situation of living donors: moods, complaints, and self-image before and after liver transplantation.
abstract: BACKGROUND
  Living donor liver transplantation (LDLT) has developed into an established therapy for terminal liver diseases. There is, however, little knowledge of the psychosocial situation of living donors. The aim of this study was to investigate the course of donors' moods, physical complaints, and self-image in the preoperative decision process and six months after surgery.
  
  
  METHODS
  Fifty-two potential donors were evaluated at the Charité Berlin. On the basis of the clinical interview, seven (13%) potential donors were not recommended for LDLT for psychosocial reasons. Twenty-six donors underwent liver resection and were re-evaluated six months after surgery. Donors' moods were investigated with the Berlin Mood Questionnaire (BMQ) and their physical complaints were assessed by the Giessen Complaint Questionnaire (GCQ). The Narcissism Inventory (NI-90) was used to assess their self-image.
  
  
  RESULTS
  Potential donors who were not recommended for surgery showed significantly higher values for negative moods, physical complaints, and 'narcissistic rage". After surgery, donors' self-images were generally stabilized. Nevertheless, five donors (19%) showed high values for "threatened self" before and after transplantation, as well as high values for negative moods and complaints after LDLT.
  
  
  CONCLUSIONS
  The resection of the right hepatic lobe holds promise of a good psychosocial outcome, with stable self-image and self-esteem for most donors. A minority of donors exhibited enhanced perception of distress and low self-esteem before and after surgery, which can easily be overlooked in the preoperative evaluation. A psychometric assessment of self-image before transplantation should be added to the clinical interview evaluation of potential living donors.
authors.affiliation: Psychiatric University Clinic, University of Basel, Basel, Switzerland. marc.walter@upkbs.ch
authors.forename: Marc
authors.initials: M
authors.lastname: Walter
authors.forename: Gerhard
authors.initials: G
authors.lastname: Dammann
authors.forename: Joachim
authors.initials: J
authors.lastname: Küchenhoff
authors.forename: Jörg
authors.initials: J
authors.lastname: Frommer
authors.forename: Frank
authors.initials: F
authors.lastname: Schoeneich
authors.forename: Gerhard
authors.initials: G
authors.lastname: Danzer
authors.forename: Burghard F
authors.initials: BF
authors.lastname: Klapp
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D004644:Emotions; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012649:Self Concept