title: Psychosocial Outcomes 3 to 10 Years After Donation in the Adult to Adult Living Donor Liver Transplantation Cohort Study.
abstract: BACKGROUND
  Studies of liver donors' psychosocial outcomes focus on the short term and rely largely on quality-of-life measures not specific to donation. We sought to examine long-term donation effects on 3 psychosocial domains: perceived physical, emotional, and socioeconomic outcomes.
  
  
  METHODS
  Individuals donating 3 to 10 years previously at 9 centers were eligible for telephone surveys. Survey responses were examined descriptively. Cluster analysis was used to identify distinct donor groups based on response profiles across psychosocial domains. Potential predictors of response profiles were evaluated with regression analysis.
  
  
  RESULTS
  Five hundred seventeen donors (66%) participated (M = 5.8 years postdonation, SD = 1.9). Fifteen percent to 48% of donors endorsed current donation-related physical health problems and concerns, and 7%-60% reported socioeconomic concerns (eg, insurance difficulties, financial expenditures). However, on average, donors experienced high psychological growth, and 90% felt positively about donation. Cluster analysis revealed 5 donor groups. One group showed high psychological benefit, with little endorsement of physical or socioeconomic concerns (15% of donors). Four groups showed less favorable profiles, with varying combinations of difficulties. The largest such group showed high endorsement of physical concerns and financial expenditures, and only modest psychological benefit (31% of donors). Men and nonHispanic whites were most likely to have unfavorable response profiles (Ps < 0.01). Compared with donors aged 19 to 30 years, older donors were less likely to have unfavorable profiles; these differences were significant for donors in the >40 to 50 year age group (Ps < 0.008).
  
  
  CONCLUSIONS
  Even many years postdonation, donors report adverse physical and socioeconomic effects, but positive emotional effects as well. Identification of response profiles and predictors may improve targeting of postdonation surveillance and care.
authors.affiliation: 1 Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA. 2 Department of Psychology, University of Pittsburgh, Pittsburgh, PA. 3 Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA. 4 Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA. 5 Department of Surgery, University of Pittsburgh, Pittsburgh, PA. 6 Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Chicago, IL. 7 Comprehensive Transplant Center, Northwestern University, Chicago, IL. 8 Lahey Hospital and Medical Center Clinical Research and Education, Burlington, MA. 9 Department of Transplantation, Lahey Hospital and Medical Center, Burlington, MA. 10 Department of Biostatistics, University of Michigan, Ann Arbor, MI. 11 Department of Surgery, University of Michigan, Ann Arbor, MI. 12 Arbor Research Collaborative for Health, Ann Arbor, MI. 13 Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada. 14 Liver Diseases Research Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. 15 Department of Psychiatry, University of Pennsylvania, Philadelphia, PA. 16 Department of Transplant Surgery, Virginia Commonwealth University, Richmond, VA. 17 Department of Surgery, Columbia University Medical Center, New York, NY. 18 Department of Surgery, University of California at San Francisco, San Francisco, CA. 19 Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO. 20 Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL. 21 Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.forename: Andrea F
authors.initials: AF
authors.lastname: DiMartini
authors.forename: Daniela P
authors.initials: DP
authors.lastname: Ladner
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Simpson
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Pomfret
authors.forename: Brenda W
authors.initials: BW
authors.lastname: Gillespie
authors.forename: Robert M
authors.initials: RM
authors.lastname: Merion
authors.forename: Jarcy
authors.initials: J
authors.lastname: Zee
authors.forename: Abigail R
authors.initials: AR
authors.lastname: Smith
authors.forename: Susan
authors.initials: S
authors.lastname: Holtzman
authors.forename: Averell H
authors.initials: AH
authors.lastname: Sherker
authors.forename: Robert
authors.initials: R
authors.lastname: Weinrieb
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fisher
authors.forename: Jean C
authors.initials: JC
authors.lastname: Emond
authors.forename: Chris E
authors.initials: CE
authors.lastname: Freise
authors.forename: James R
authors.initials: JR
authors.lastname: Burton
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Butt
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017093:Liver Failure / Q000523:psychology* / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods* / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D012107:Research Design; D012923:Social Class; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult