Trotter J F, Talamantes M, McClure M, Wachs M, Bak T, Trouillot T, Kugelmas M, Everson G T, Kam I
Division of Gastroenterology/Hepatology, University of Colorado Health Sciences Center, Denver, CO 80262, USA.
Liver Transpl. 2001 Jun;7(6):485-93. doi: 10.1053/jlts.2001.24646.
Adult right hepatic lobe living donor liver transplantation (LDLT) has rapidly gained widespread acceptance as an effective procedure for selected patients with end-stage liver disease. However, there are currently no published data on the effect of this procedure on the quality of life of donors. We report the results of a survey of our living liver transplant donors to determine the effect of right hepatic lobe donation on quality of life. We have performed 30 LDLTs since 1997; 24 of these have a follow-up of 4 months or longer. In August 2000, these patients were sent a questionnaire (including a Medical Outcomes Study 36-Item Short-Form Survey) regarding psychosocial outcomes and symptoms after surgery. Major complications occurred in 4 of 24 patients (16%), and minor complications, in 4 of 24 patients (16%). Complete recovery occurred in 75% of patients at a mean time of 3.4 months. Ninety-six percent of patients returned to the same predonation job after a mean time of 2.4 months, and 66% of patients required a period of light-duty work for a mean of 2.8 months before returning to full-duty work. A change in body image was reported in 42% of patients, and 71% reported mild ongoing symptoms (primarily abdominal discomfort) that they related to the donor surgery for which 29% sought evaluation by a physician. The donor's relationship with the recipient was the same or better in 96% of donors, and the relationship with the donor's significant other was the same or better in 88% of donors. Mean out-of-pocket expenses incurred by donors were $3,660. Sixty-three percent of donors reported experiencing more pain than anticipated. All patients would donate again if necessary, and 96% benefited from the donor experience. In conclusion, (1) all our donors are alive and well after donation; (2) almost all donors were able to return to predonation employment status within a few months; (3) most donors have mild persistent abdominal symptoms, and some donors had a change in body image that they attribute to the donor surgery; and (4) this information should be provided to potential donors so they may better understand the impact of donor surgery.
成人右肝叶活体肝移植（LDLT）作为一种针对特定终末期肝病患者的有效手术，已迅速获得广泛认可。然而，目前尚无关于该手术对供体生活质量影响的公开数据。我们报告了一项对活体肝移植供体的调查结果，以确定右肝叶捐赠对生活质量的影响。自1997年以来，我们共进行了30例LDLT手术；其中24例有4个月或更长时间的随访。2000年8月，向这些患者发送了一份关于术后心理社会结果和症状的问卷（包括医学结局研究36项简表调查）。24例患者中有4例（16%）发生了严重并发症，24例患者中有4例（16%）发生了轻微并发症。75%的患者在平均3.4个月时完全康复。96%的患者在平均2.4个月后回到了捐赠前的工作岗位，66%的患者在回到全职工作前需要一段平均2.8个月的轻体力工作期。42%的患者报告身体形象有变化，71%的患者报告有轻微的持续症状（主要是腹部不适），他们认为这些症状与供体手术有关，其中29%的患者寻求医生评估。96%的供体与受者的关系保持不变或更好，88%的供体与重要他人的关系保持不变或更好。供体平均自付费用为3660美元。63%的供体报告疼痛比预期更严重。所有患者在必要时都愿意再次捐赠，96%的患者从捐赠经历中受益。总之，（1）我们所有的供体在捐赠后都健在且状况良好；（2）几乎所有供体都能在几个月内恢复到捐赠前的就业状态；（3）大多数供体有轻微的持续性腹部症状，一些供体的身体形象有变化，他们将其归因于供体手术；（4）应将这些信息提供给潜在供体，以便他们能更好地了解供体手术的影响。
