title: Long-term quality of life after liver donation in the adult to adult living donor liver transplantation cohort study (A2ALL).
abstract: OBJECTIVE
  There are few long-term studies of the health-related quality of life (HRQOL) in living liver donors. This study aimed to characterize donor HRQOL in the Adult to Adult Living Donor Liver Transplantation Study (A2ALL) up to 11 years post-donation.
  
  
  METHODS
  Between 2004 and 2013, HRQOL was assessed at evaluation, at 3 months, and yearly post-donation in prevalent liver donors using the short-form survey (SF-36), which provides a physical (PCS) and a mental component summary (MCS).
  
  
  RESULTS
  Of the 458 donors enrolled in A2ALL, 374 (82%) had SF-36 data. Mean age at evaluation was 38 (range 18-63), 47% were male, 93% white, and 43% had a bachelor's degree or higher. MCS and PCS means were above the US population at all time points. However, at every time point there were some donors who reported poor scores (>1/2 standard deviation below the age and sex adjusted mean) (PCS: 5.3-26.8%,
  10.0-25.0%). Predictors of poor PCS and MCS scores included recipient's death within the two years prior to the survey and education less than a bachelor's degree; poor PCS scores were also predicted by time since donation, Hispanic ethnicity, and at the 3-month post-donation time point.
  
  
  CONCLUSIONS
  In summary, most living donors maintain above average HRQOL up to 11 years prospectively, supporting the notion that living donation does not negatively affect HRQOL. However, targeted support for donors at risk for poor HRQOL may improve overall HRQOL outcomes for living liver donors.
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL, USA. Electronic address: dladner@nmh.org.
authors.forename: Daniela P
authors.initials: DP
authors.lastname: Ladner
authors.affiliation: Departments of Psychiatry, Psychology, Epidemiology and Biostatistics, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, PA, USA.
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.affiliation: Arbor Research Collaborative for Health, Ann Arbor, MI, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Forney
authors.affiliation: Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Brenda W
authors.initials: BW
authors.lastname: Gillespie
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Brown
authors.affiliation: Arbor Research Collaborative for Health, Ann Arbor, MI, USA; Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Merion
authors.affiliation: Department of Surgery, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Chris E
authors.initials: CE
authors.lastname: Freise
authors.affiliation: Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Hayashi
authors.affiliation: Department of Surgery, Medical College of Wisconsin, WI, USA.
authors.forename: Johnny C
authors.initials: JC
authors.lastname: Hong
authors.affiliation: Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: April
authors.initials: A
authors.lastname: Ashworth
authors.affiliation: Duke University Health System, Durham, NC, USA.
authors.forename: Carl L
authors.initials: CL
authors.lastname: Berg
authors.affiliation: Department of Medicine, University of Colorado, Aurora, CO, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Burton
authors.affiliation: Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Abraham
authors.initials: A
authors.lastname: Shaked
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Butt
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D009927:Tissue and Organ Procurement; D055815:Young Adult
keywords: Adult to adult living donor liver transplantation cohort study (A2ALL); Living donor liver transplantation; Living liver donors; Patient reported outcomes; Quality of life