Donor Quality of Life up to Two Years After Living Donor Liver Transplantation: A Prospective Study

Kroencke, Sylvia1; Nashan, Björn2; Fischer, Lutz2; Erim, Yesim3; Schulz, Karl-Heinz1,4

Transplantation:
doi: 10.1097/01.TP.0000438206.04348.b2
Clinical and Translational Research
Abstract

Background: There is a lack of longer-term prospective data on living liver donors’ quality of life (QOL). This is the first prospective study examining QOL up to 2 years after donation.

Methods: A consecutive sample of living donors (n=40) was compared with a sample of potential donors (n=27) with respect to QOL, anxiety, and depression. Performing mixed-effects model analysis, both groups were assessed before transplantation, with and without simultaneous donation (T0), and at three postoperative data points: 3 months (T1), 1 year (T2), and 2 years (T3). Subsequently, both groups were compared with reference data of the general population and healthy individuals.

Results: At T1, living donors’ physical QOL was impaired. At T2 and T3, physical QOL was slightly lower than the preoperative level but within the range of healthy individuals in both living donors and potential donors. Neither mental QOL nor depression showed significant changes across time, while anxiety decreased in both groups. Subgroup analysis of adult-to-adult (AA) donors and adult-to-pediatric (AP) donors revealed different trajectories of mental QOL, anxiety, and depression. AP donors experienced more preoperative psychological strain, which improved after donation, whereas AA donors showed unchanged anxiety and depression, and a slight decrease in mental QOL 2 years after surgery. Two AA donors, whose recipients had died, reported persisting depressive symptoms after donation.

Conclusions: One and two years after donation, QOL is not substantially impaired in the majority of donors. Future research needs to provide an even longer prospective follow-up and should more rigorously explore risk factors for a negative donor outcome.

Author Information

1 Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

2 Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

3 Department of Psychosomatics and Psychotherapy, Erlangen University Hospital, Erlangen, Germany.

4 Address correspondence to: Prof. Karl-Heinz Schulz, M.D., Ph.D., Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W26, 20246 Hamburg, Germany.

This work was supported by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) through grants SCHU 974/5-1/2 and SCHU 974/6-1 (S.K., K.-H.S., and Y.E.). B.N. and L.F. have not received any grants for this study.

The authors declare no conflicts of interest.

E-mail: khschulz@uke.de

S.K. participated in designing and performing the research, analyzing the data, and writing the article. K.-H.S. participated in designing the study, analyzing the data, and writing the article. B.N. and L.F. participated in performing the research and analyzing the data. Y.E. participated in designing the study and performing the research.

Supplemental digital content (SDC) is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.transplantjournal.com).

Received 12 June 2013. Revision requested 8 September 2013.

Accepted 24 September 2013.

Accepted December 27, 2013

© 2014 by Lippincott Williams & Wilkins