Donor quality of life before and after adult-to-adult right liver live donor liver transplantation

Abstract

Donor right hepatectomy for adult-to-adult live donor liver transplantation (ALDLT) is a major surgical operation for the benefit of the recipient. Justification of procedure mandates knowledge of the possible physical and psychological negative effects on the donor. We prospectively and longitudinally quantified donor quality of life using generic and condition-specific questionnaires up to 1 year. The generic questionnaires were the Karnofsky Performance Status scale and the Chinese (Hong Kong) version of the Medical Outcomes Study 36-Item Short-Form Survey, which measures 8 health concepts: 4 physical components and 4 mental components. Within 1 year, 30 consecutive donors were included. These 11 male and 19 female donors (36.7% and 63.3%, respectively) had a median age of 35 years (range, 21-56 years). There was no donor mortality or major complications. Donor quality-of-life worsening was most significant in the first 3 postoperative months, particularly among the physical components. The physical and mental components returned to the previous levels in 6 to 12 months' time, though the Karnofsky performance scores were slightly lower at 1 year (P ϭ 0.011). Twenty-six (86.7%) donors declared that they would donate again if there were such a need and it were technically possible. It was noticed that older donors were more likely to express unwillingness to donate again. In conclusion, the temporary worsening of donor quality of life substantiates ALDLT as an acceptable treatment modality. Liver Transpl 12: 1529-1536, 2006.

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“…The current literature provides several studies examining HRQoL in liver donors, in which the number of patients ranged between 22 and 127. 13,14,[33][34][35][36][37][38][39][40][41] The SF-36 is the most frequently used tool for measurement of HRQoL, and the scores are comparable to the findings in our present study. [34][35][36][37]40,41 Compared with the HRQoL shown in the general population, liver donors had equal scores in most examinations.…”

“…33 The physical aspects of HRQoL appear to be especially decreased in the early postoperative period. 13,36,37 Further risk factors for an impairment of the donors' HRQoL are the death of the recipient 34 and predonation concerns and time to donation > 4 weeks. 35 Regarding the influence of postoperative complications on HRQoL, there are controversial findings.…”

“…Several studies have investigated the HRQoL after LDLT and have shown that physical well-being decreases during the immediate postoperative period but returns to levels of the general population within 1 year after donation, whereas the mental well-being appears to be stable during this process. [10][11][12][13] Parameters such as the graft type (left or right lobe), donor age, the urgency of the recipient's need for transplant, postoperative and other donor complications, and posttransplant recipient morbidity and mortality were also identified as possible important negative predictive parameters for a poor HRQoL in donors. [14][15][16] However, most studies have been limited by their small sample size, a retrospective single-center study design, and a lack of a standardized assessment of donor HRQoL parameters.…”

Donor Safety in Live-Related Liver Transplantation

“…It is undeniable that the majority of donors suffer physically, mentally and socially in the first few months after the donor operation [36].…”

“…However, none of them received any ongoing medical treatment [36]. Two-thirds of the donors considered their recoveries complete.…”