title: Discrepancy in Psychological Attitudes Toward Living Donor Liver Transplantation Between Recipients and Donors.
abstract: BACKGROUND
  Mutual understanding between recipients and donors is indispensable when living donor liver transplantation (LDLT) is performed, which, however, has gained little attention and remains unaddressed in the literature.
  
  
  METHODS
  Fifty-seven pairs, a recipient (mean ± SD age at the operation, 48.3 ± 10.6 years; mean ± SD years after the operation, 6.2 ± 4.7 years) and his or her donor, who underwent LDLT completed a 13-item questionnaire on a 7-point Likert scale (1: strongly agree to 7: strongly disagree) that was designed to assess for their psychological attitudes toward transplantation. They were also asked to estimate their donor's or recipient's response to the questionnaire, respectively. Values of interest were compared between groups, using paired t tests. Following Bonferroni correction, a P value less than 0.0038 (0.05/13) was considered statistically significant.
  
  
  RESULTS
  Significant differences were observed between actually answered and estimated responses in 7 of the 13 items in the questionnaire for donors. For example, donors did not feel pressure to become a donor to the same degree as their recipients estimated (4.6 ± 1.9 vs 3.4 ± 1.8). In contrast, only 1 item showed a significant difference between actually answered and estimated responses in the questionnaire for recipients; recipients did not worry about the transplanted liver compared to their donors' estimation (3.1 ± 1.9 vs 2.1 ± 0.8).
  
  
  CONCLUSIONS
  Recipients did not fully understand the donors' feelings toward LDLT, whereas donors almost correctly understood their recipients' attitudes. Our findings clearly revealed the gap in their mutual understanding and emphasize the need of psychological education to bridge the gap.
authors.affiliation: 1 Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan. 2 Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada. 3 Department of Nursing, Keio University Hospital, Tokyo, Japan. 4 Department of Surgery, Keio University School of Medicine, Tokyo, Japan. 5 Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Hayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uchida
authors.forename: Chie
authors.initials: C
authors.lastname: Takaoka
authors.forename: Yuka
authors.initials: Y
authors.lastname: Izawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinoda
authors.forename: Hideaki
authors.initials: H
authors.lastname: Obara
authors.forename: Osamu
authors.initials: O
authors.lastname: Itano
authors.forename: Joichiro
authors.initials: J
authors.lastname: Shirahase
authors.forename: Minoru
authors.initials: M
authors.lastname: Tanabe
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Mimura
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D058625:End Stage Liver Disease / Q000000981:diagnostic imaging / Q000523:psychology; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D066027:Transplant Recipients / Q000523:psychology*; D014463:Ultrasonography