The long-term psychosocial impact of liver donation

In order for potential liver donors to be fully informed about the risks of donation, they need to have information about the long-term impacts of donation. Studies have examined liver donors’ long-term medical outcomes, but there have been no analogous studies on long-term psychosocial outcomes. To address this gap, researchers examined data from the Adult to Adult Living Donor Liver Transplantation Cohort Study-2 (A2ALL-2) to learn about clinically significant mental health problems and self-reported physical health problems in the long-term years after liver donation.

Investigators collected data through phone interviews with over 400 donors between three and ten years after donation and compared the responses to general population norms. Donors reported normal levels of major depression and pain, and significantly less fatigue than the general population. However, donors’ anxiety disorder rate and alcohol use disorder rate were higher than normal at one or more points during the follow-up period.

Several donor characteristics were associated with increased risk for most outcomes: 

  • Longer postdonation hospitalization 
  • Female sex 
  • Higher body mass index (BMI) 
  • Concerns about donation-related health effects 
  • Burdensome donation-related financial costs

Additionally, men were at higher risk for alcohol use disorder.

While most liver donors will not experience these difficulties, this study highlights that a subset of donors are at risk for mental and physical health problems. Anxiety and alcohol use in particular may warrant more attention, both in research and clinical surveillance efforts to target donors at highest risk for such problems.

“There is so little work focused on long-term psychosocial outcomes in living liver donors that I would emphasize the need to follow cohorts into the long-term years,” added lead author Dr. Mary Amanda Dew. “Liver donors deserve the same attention in the long-term years as the attention now being given to kidney donors.”

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CITATION:Dew MA, Butt Z, Liu Q, Simpson MA, Zee J, Ladner DP, Holtzman S, Smith AR, Pomfret EA, Merion RM, Gillespie BW, Sherker AH, Fisher RA, Olthoff KM, Burton JR, Terrault NA, Fox AN, DiMartini AF. Prevalence and predictors of patient-reported long-term mental and physical health after donation in the Adult-to-Adult Living-Donor Liver Transplantation Cohort Study. Transplantation 2018;102(1):105-118.
PubMed:www.ncbi.nlm.nih.gov/pubmed/28885494
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