Long-Term Quality of Life and Psychological Outcomes in Live Donors Following Paediatric and Adult Living Donor Liver Transplantation: A Belgian Experience.

Abstract

Abstract Background With an increasing shortage of deceased donors for liver transplantation, living donor liver transplantation (LDLT) poses a valuable alternative. Therefore, it is important to investigate the risks healthy donors face during and after this procedure. We investigated complications and their impact on long-term health-related quality of life (HRQoL) and physical and mental functioning. Methods Thirty-three out of 51 Belgian liver donors who underwent a donor hepatectomy at the Ghent University Hospital from 1/1/2000 – 31/12/2015 consented to participate. Blood samples, a liver ultrasound, a clinical examination by a liver surgeon, and a socio-psychological interview supervised by a transplant psychologist were conducted. Additionally, participants completed a survey that examined the HRQoL (SF-36 and EQ-5D-3L), Depression, anxiety and stress (DASS), and donor experiences. Fischer’s exact, Mann-Whitney-U test, and Kruskal-Wallis tests were used, and statistical analysis was performed with SPSS 27.0. Results Donor complications were recorded in 24.8% without relation to long-term mental QoL and physical symptoms. Type of lobe donation had no significant effect on HRQoL, mood, anxiety and stress, and complications. Recipient complications and death, negative mood, anxiety, and stress were found to be related to a lower donor physical and mental HRQoL. Patients donating to pediatric recipients scored significantly better for mental and physical HRQoL. Conclusions Generally, donor experience is positive, with own complications having no lasting effect on QoL and mental health, however, complications in the recipient are more difficult to cope with and impact the mental HRQoL of the donor. LDLT in Belgium is ready to be standardized care for end-stage liver disease.