title: Long-term follow-up after right hepatectomy for adult living donation and attitudes toward the procedure.
abstract: OBJECTIVE
  To determine the long-term health status of donors after right hepatectomy for adult live donor liver transplantation (ALDLT).
  
  
  BACKGROUND
  The long-term outcomes for ALDLT donors are unknown.
  
  
  METHODS
  ALDLT donors undergoing right hepatectomy from April 1998 to June 2007 were invited to complete a questionnaire regarding health status, satisfaction (1-10/worst-best scale), self-esteem, willingness to donate again, and suggestions for improvement. In addition, donor files and cholecystectomy specimens were reviewed. Fisher's exact test, Kaplan-Meier and logistic regression analyses were performed.
  
  
  RESULTS
  Eighty-three donors were contacted (median age: 36 years; median follow-up: 69 months). 39 (47%) were free of symptoms. The remaining 44 (53%) reported: intolerance to fatty meals and diarrhea (31%), gastroesophageal reflux associated with left liver hypertrophy (9%), incisional discomfort requiring pain medications (6%), severe depression requiring hospitalization (4%), rib pain affecting lifestyle (2%), and exacerbation of psoriasis (1%). Median satisfaction score was 8. Self-esteem diminished in 5%. Thirty-nine (47%) recommended improvements particularly more detailed informed donor consent and a centralized living donor liver registry. Seventy-eight (94%) were willing to donate again. There were no differences between donors with and without complaints with respect to: donor age, gender, early complications and follow-up time, young-to-old donation, recipient diagnosis of malignancy and death of the recipient. Noninflamed donor cholecystectomy specimens correlated with intolerance to fatty meals and diarrhea (P = 0.001).
  
  
  CONCLUSIONS
  ALDLT donors are at risk for long-term complaints that are neither reflected nor related to early complications. This information should be included in both the donor evaluation and the ALDLT decision-making process.
authors: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Germany. georgios.sotiropoulos@uni-due.de
authors: Georgios C
authors: GC
authors: Sotiropoulos
authors: Arnold
authors: A
authors: Radtke
authors: Ernesto P
authors: EP
authors: Molmenti
authors: Tobias
authors: T
authors: Schroeder
authors: Hideo A
authors: HA
authors: Baba
authors: Andrea
authors: A
authors: Frilling
authors: Christoph E
authors: CE
authors: Broelsch
authors: Massimo
authors: M
authors: Malagó
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D002763:Cholecystectomy; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006498:Hepatectomy / Q000009:adverse effects / Q000523:psychology; D006525:Hepatitis, Viral, Human / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D008115:Liver Regeneration; D016031:Liver Transplantation; D019520:Living Donors / Q000523:psychology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D055815:Young Adult