Feelings of Living Donors About Adult-to-Adult Living Donor Liver Transplantation

Abstract

This study investigated the feelings of living donors about adult-to-adult liver transplantation. We interviewed 18 donors about their feelings before and after transplantation using semistructured interviews and then conducted a content analysis of their responses. Before transplantation, many donors reported that they wanted recipients to live for the donor or his or her family, and there was no one else to donate. Many donors were not anxious, did not feel coerced, and did not consider donation dangerous. Some reported being excited at facing a new experience. Some said they would not mind whatever happens. Others were anxious or unsure about the operation. Diagnostic testing and preoperative blood banking were painful. Donors experienced increasing stress just before the operation. After transplantation, some donors verbalized feeling more grateful to others and that they gained maturity. Throughout the process, donors were concerned about their recipients. Our results suggest that donors might act for themselves or their family. It is important to recognize the varied responses of donors' feelings toward liver transplant recipients.

Informed Consent for Living Donation: A Review of Key Empirical Studies, Ethical Challenges and Future Research

“…Similarly, a recent systematic review of informed consent for LLDs found that most LDs reported high levels of comprehension (up to 94% of donors) of information disclosed about the donation process and risks (23). However, studies also found LLDs' gaps in knowledge and perceptions of the magnitude of risks involved in hepatectomy (53)(54)(55)(56)(57)(58)(59).…”

“…For example, LKDs report experiencing more painful surgery and recovery than expected (34%) (61). Consequently, LKDs (60) and LLDs report desiring more information to prepare for donation (53,61), and perceive the lack of information on certain aspects of the procedure as a major source of concern and anxiety (54,55). LLDs reported limited knowledge about the donation process and procedure, and did not know what questions to ask during evaluation (57,59).…”

“…Pressures may be internal or self-generated (65,66), or external based on social and emotional pressures from the recipient or family, financial, religious or cultural (25,65,66). For example, while European LDs reported feeling like they could not decline or disappoint the recipient, or they financially relied on the recipient (55,59,67), Asian LDs reported feeling "no choice" in light of cultural values that place greater importance on family unity over the individual family member (55,65). In developing countries, where the costs of dialysis are exorbitant and transplant legislation and infrastructure for deceased donation are largely absent, patients with chronic kidney disease have little option but to seek a living donor transplant (68,69).…”

Psychosocial Outcomes 3 to 10 Years After Donation in the Adult to Adult Living Donor Liver Transplantation Cohort Study

“…6–8,12,14–16,18–21 Additionally, donors almost uniformly express no regret about donation, and report deep gratification at helping another person. 15,17,19,23 Nevertheless, some single-center studies suggest that significant percentages of liver donors experience psychosocial difficulties postdonation. For example, up to 33% of donors report poorer health postdonation, 15–17 up to 50% worry about lasting health effects, 24,25 and over 25% have financial hardships, with prominent concerns about current and future insurance status.…”

The Quality of Life of Living Liver Fragment Donors

“…Интересно, что в 2008 году Kusakabe [59], про-водя опрос 18 доноров фрагмента печени, показал высокую вариативность ответов доноров в оценке собственного психического состояния и разнообра-зие подходов в отношении к реципиенту.…”