Walter M, Dammann G, Papachristou C, Pascher A, Neuhaus P, Danzer G, Klapp B F
Psychiatric University Clinic, Willhelm Klein-Strasse 27, CH-4025 Basel, Switzerland.
Transplant Proc. 2003 Dec;35(8):2961-3. doi: 10.1016/j.transproceed.2003.10.048.
Living donor liver transplantation (LDLT) is becoming an established method for treatment of terminal liver disease in adults. After resection of the right hepatic lobe, postoperative complications can arise in healthy donors, and even individual cases of death have been recorded. There remains, however, little research on the psychosocial aspects in living donors before and after LDLT. Using the WHOQOL questionnaire, this prospective study investigates the quality of life (QoL) in a sample of 28 living donors, including the relationship between postoperative complications and QoL before and 6 months after donation. Before LDLT, the donor QoL is high, above that of the general healthy population. After LDLT, a significant reduction in the QoL appears in the areas of "physical health" and "living conditions." Nevertheless, the QoL remains above the level of the general population. Only two donors showed general QoL values below those of the general population. The postoperative complications had no significant influence on the QoL after transplantation. The high QoL of donors following LDLT indicates a positive psychosocial outcome for the majority of donors, irrespective of donation-related complications. Additional psychosocial studies will be necessary to disclose predictors for an unfavorable psychosocial outcome following LDLT.
活体肝移植(LDLT)正成为治疗成人终末期肝病的一种成熟方法。在切除右肝叶后,健康供体可能会出现术后并发症,甚至有个别死亡病例的记录。然而,关于活体供体在LDLT前后的心理社会方面的研究仍然很少。本前瞻性研究使用世界卫生组织生活质量问卷(WHOQOL),对28名活体供体样本的生活质量(QoL)进行了调查,包括术后并发症与捐献前及捐献后6个月QoL之间的关系。在LDLT之前,供体的QoL较高,高于一般健康人群。LDLT之后,“身体健康”和“生活条件”方面的QoL出现了显著下降。尽管如此,QoL仍高于一般人群的水平。只有两名供体的总体QoL值低于一般人群。术后并发症对移植后的QoL没有显著影响。LDLT后供体的高QoL表明,对于大多数供体来说,无论与捐献相关的并发症如何,心理社会结果都是积极的。需要进行更多的心理社会研究,以揭示LDLT后心理社会结果不佳的预测因素。