[Living donor liver transplantation from the perspective of the donor: results of a psychosomatic investigation].
OBJECTIVE
Living donor liver transplantation (LDLT) has been gaining importance in the treatment of endstage liver disease in adults. Thus far, only few empirical studies have been published on the psychosocial situation of donors who are faced with the risk of medical complications after resection of the right hepatic lobe. The aims were to describe the clinical problems before and after transplantation and to contribute to the discussion of ethical issues based on empirical findings.


METHODS
In the present overview, the pre-/post-transplant and follow-up periods are characterized from a psychosocial point of view using actual psychosocial and medical findings in living donors of the right hepatic lobe.


RESULTS
Before LDLT, 11 % of potential donors were not recommended for the transplantation due to marked ambivalence about the operation. After donation 26 % of donors showed high values for anxious depression and physical complaints despite low rates of surgical complications.


CONCLUSIONS
For clinical psychosomatic evaluations of potential donors it is important to provide donors an opportunity to report any misgivings and anxieties as openly as possible. The psychosocial impairment and physical complaints of some donors after transplantation are yet not clearly understood. More psychosocial studies in this field will be necessary to investigate ethical questions and to develop criteria for an evidence-based medical care of living donors.
Walter
Marc
M
Medizinische Klinik mit Schwerpunkt Psychosomatik der Charité, Berlin, Germany. marc.walter@pukbasel.ch
Pascher
Andreas
A
Jonas
Sven
S
Danzer
Gerhard
G
Frommer
Jörg
J
Neuhaus
Peter
P
Klapp
Burghard F
BF
D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D004992:Ethics, Medical; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000941:ethics / Q000523:psychology*; D006801:Humans; D016031:Liver Transplantation / Q000941:ethics / Q000523:psychology*; D019520:Living Donors / Q000941:ethics / Q000523:psychology*; D011183:Postoperative Complications / Q000523:psychology*; D017410:Practice Guidelines as Topic; D013001:Somatoform Disorders / Q000523:psychology*