title: Long-Term Medical and Psychosocial Outcomes in Living Liver Donors.
abstract: Due to the enduring organ shortage, living donor liver transplantation has been a valuable treatment strategy for advanced liver disease patients for over 20 years. A variety of reviews have summarized the extensive data now available on medical and psychosocial risks to living donors in the aftermath of donation. However, evidence on donor medical and psychosocial outcomes beyond the first year postdonation has not been synthesized in any previous review. The evidence base on such "long-term" outcomes has been growing in recent years. A review of this evidence would therefore be timely and could serve as an important resource to assist transplant centers in their efforts to fully educate prospective donors and gain informed consent, as well as develop appropriate postdonation clinical care and surveillance plans. We reviewed recent literature on long-term donor outcomes, considering (a) medical outcomes, including mortality risk, rates of complications, abnormalities detected in laboratory testing, and the progress of liver regeneration; and (b) donor-reported psychosocial outcomes reflecting physical, emotional, and interpersonal/socioeconomic well-being, as well as overall health-related quality of life. We summarize limitations and gaps in available evidence, and we provide recommendations for future research and clinical care activities focused on long-term outcomes in liver donors.
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.|Department of Psychology, University of Pittsburgh, Pittsburgh, PA.|Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.|Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA.
authors.forename: M A
authors.identifier: 0000-0002-4666-1870
authors.initials: MA
authors.lastname: Dew
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.|Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.|Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL.
authors.forename: Z
authors.initials: Z
authors.lastname: Butt
authors.affiliation: Department of Surgery, University of Pittsburgh, Pittsburgh, PA.|Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: A
authors.initials: A
authors.lastname: Humar
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.|Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
authors.forename: A F
authors.initials: AF
authors.lastname: DiMartini
mesh_terms: D006801:Humans; D008115:Liver Regeneration / Q000502:physiology*; D016031:Liver Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D011788:Quality of Life; D013997:Time Factors
keywords: clinical research/practice; complication; donors and donation: donor follow-up; health services and outcomes research; liver transplantation/hepatology; liver transplantation: living donor; quality of life (QOL)