title: Psychological strain in urgent indications for living donor liver transplantation.
abstract: The ethical soundness of living donor liver transplantation (LDLT) in urgent indications is still under discussion. The aim of the survey was to investigate the psychological distress of donors in cases of hepatocellular carcinoma (HCC) or acute liver failure (ALF). In a prospective multicenter study (n = 123), health-related quality of life (QOL), anxiety, and depression were measured. The psychological distress of donors was correlated to the degree of urgency of the recipients' indication, which was classified as nonurgent, HCC, or ALF. During the donor evaluation prior to LDLT, the donors with recipients for HCC and ALF demonstrated significantly reduced mental QOL in comparison to donors for a nonurgent indication and to the German normative sample. Compared to healthy controls, anxiety and depression were significantly increased in donors for ALF. Three months after the transplantation, scores for mental QOL as well as for anxiety and depression improved and were within the normal range for the whole group as well as for the ALF donors. In conclusion, the psychological burden was temporary in nature. Our findings can be considered as arguments for the current practice to address family members as donors in cases of HCC and ALF.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Essen, Essen, Germany. yesim.erim@uni-essen.de
authors.forename: Yesim
authors.initials: Y
authors.lastname: Erim
authors.forename: Mingo
authors.initials: M
authors.lastname: Beckmann
authors.forename: Sylvia
authors.initials: S
authors.lastname: Kroencke
authors.forename: Camino
authors.initials: C
authors.lastname: Valentin-Gamazo
authors.forename: Massimo
authors.initials: M
authors.lastname: Malago
authors.forename: Dieter
authors.initials: D
authors.lastname: Broering
authors.forename: Xavier
authors.initials: X
authors.lastname: Rogiers
authors.forename: Andrea
authors.initials: A
authors.lastname: Frilling
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Schulz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000523:psychology*; D046148:Donor Selection; D005260:Female; D006801:Humans; D007223:Infant; D017114:Liver Failure, Acute / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome