title: Importance of awareness of perioperative social and physical situations of living donors for liver transplantation.
abstract: BACKGROUND
  Transplantation in Japan still depends on living donors even after the new revised law. We must pay attention to protect living donors.
  
  
  METHODS
  Perioperative qualities of life after living donation for liver transplantation were assessed with questionnaires including the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF36-v2). Nonparametric Mann-Whitney tests were used to determine statistical significance. P values<.05 were considered significant.
  
  
  RESULTS
  Thirty-one among 33 donors answered questionnaires (93.9%). The 15 men and 16 women of average age of 39.7 years had a median hospital stay of 16 days and median duration after surgery of 78 months. Ten of 33 (35.7%) donors considered themselves to be the only possibility. The decision to a donor was established prior to informed consent in 23 donors (74.1%). Six months were required for them to experience a full recovery after donor surgery. Hamilton depression/anxiety score was significantly increased among donors who considered themselves to be the only possibility or those who had decided prior to informed consent. SF36-v2 revealed a significant decrease in social functioning among donors who did not have sufficient time to decide before surgery. General health was significantly decreased among donors who required more than 6 months for full recovery. Perioperative management of pain influenced general health, physical role, bodily pain, and physical functioning.
  
  
  CONCLUSIONS
  We must pay attention to depression and anxiety among living donors. More care should be focused on pain control and sharing of information of postoperative courses.
authors.affiliation: Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki City, Japan. Shunji@cc.hirosaki-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Narumi
authors.forename: M
authors.initials: M
authors.lastname: Umehara
authors.forename: Y
authors.initials: Y
authors.lastname: Toyoki
authors.forename: K
authors.initials: K
authors.lastname: Ishido
authors.forename: D
authors.initials: D
authors.lastname: Kudo
authors.forename: N
authors.initials: N
authors.lastname: Kimura
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: M
authors.initials: M
authors.lastname: Sugai
authors.forename: K
authors.initials: K
authors.lastname: Hakamada
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D001364:Awareness; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000523:psychology; D006801:Humans; D007258:Informed Consent; D007564:Japan; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects / Q000523:psychology; D019520:Living Donors / Q000523:psychology; D008297:Male; D008603:Mental Health; D010149:Postoperative Pain / Q000209:etiology / Q000523:psychology; D059035:Perioperative Period; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors