Lee S H, Jeong J S, Ha H S, No M J, Hong J J, Kwon J S, Lee K H, Han D J, Lee S G
Transplantation Team and Departments of Clinical Nursing and General Surgery, University of Ulsan Asan Medical Center, Seoul, Korea.
Transplant Proc. 2005 Mar;37(2):1081-4. doi: 10.1016/j.transproceed.2005.01.032.
Living related liver transplantation (LRLT) has been performed since 1994 in Korea; more than 600 donors have contributed to our successful LRLT program for 10 years. Although the decision to donate is difficult and the donors need a formal psychosocial assessment, no system has been available to us for the assessment. This survey was performed as a presurveillance for the development of a psychosocial assessment protocol.
A survey questionnaire included 31 questions on general and medical characteristics, factors, and processes related to the decision for donation. Donors of partial livers at least 6 months ago during the period from December 1994 to August 2003 and whose address could be confirmed by telephone were enrolled in the study.
A questionnaire was sent by mail to 441 contactable donors of whom 209 (47.4%) responded. Male-to-female ratio was 2:1 and mean age was 32.8 years (range: 16 to 60 years). The number of spousal donors was 120 (57.4%) and 164 (78.5%) donors were employed at the time of donation. Protestants, Buddhists, and Catholics were 29.2%, 19.1%, and 14.8%, respectively. Parents were the most common recipients (33.0%), followed by siblings (17.2%), extended family members (17.2%), and children (15.8%); one hundred eighty nine (90.4%) donors had decided by themselves, the major reason for donation in 192 (91.9%) donors was "to save the lives of family members and relatives." The first person who suggested donation was the donor (64.1%), followed by family members (23.9%) or the attending physicians (8.6%). Although 70.8% of donors answered that they were not hesitant to donate at the time of decision, 44.5% were uneasy at the possibility of being unable to sustain a normal life after donation, at their lack of knowledge on organ donation, and about the pain and fear of surgery. Family members and relatives (53.3%), medical personnel (46.7%), and previous donors (35.4%) were the preferable counselors compared to transplantation institutions and clergymen. The large majority (80.8%) of donors would encourage others to donate.
Although the decision to donate was made by the donors themselves in most cases and they appeared firm and determined about their decision, a significant number of donors felt uneasy about possible complications of organ donation and effects on their lives after donation. A precise and formal psychosocial assessment protocol is needed to support and secure their decision before and after donation.
自1994年起韩国开始开展活体亲属肝移植（LRLT）；10年来，600多名供体为我们成功的LRLT项目做出了贡献。尽管做出捐赠的决定很困难，且供体需要进行正式的心理社会评估，但我们一直没有可用的评估系统。本次调查是为制定心理社会评估方案而进行的预监测。
调查问卷包含31个关于一般和医学特征、与捐赠决定相关的因素及过程的问题。纳入研究的供体为1994年12月至2003年8月期间至少6个月前捐献部分肝脏且其地址可通过电话确认的供体。
通过邮件向441名可联系到的供体发送了问卷，其中209名（47.4%）做出了回应。男女比例为2:1，平均年龄为32.8岁（范围：16至60岁）。配偶供体有120名（57.4%），164名（78.5%）供体在捐赠时受雇。新教徒、佛教徒和天主教徒分别占29.2%、19.1%和14.8%。父母是最常见的受者（33.0%），其次是兄弟姐妹（17.2%）、大家庭成员（17.2%）和子女（15.8%）；189名（90.4%）供体自行做出决定，192名（91.9%）供体捐赠的主要原因是“拯救家人和亲属的生命”。第一个提出捐赠的是供体（64.1%），其次是家庭成员（23.9%）或主治医生（8.6%）。尽管70.8%的供体回答在做出决定时不犹豫捐赠，但44.5%的供体因担心捐赠后无法维持正常生活、对器官捐赠知识的缺乏以及手术的疼痛和恐惧而感到不安。与移植机构和神职人员相比，家庭成员和亲属（53.3%）、医务人员（46.7%）和既往供体（35.4%）是更受欢迎的咨询对象。绝大多数（80.8%）供体愿意鼓励他人捐赠。
尽管大多数情况下捐赠决定是供体自己做出的，且他们对自己的决定显得坚定，但仍有相当数量的供体对器官捐赠可能的并发症及对捐赠后生活的影响感到不安。需要一个精确且正式的心理社会评估方案，以在捐赠前后支持并确保他们的决定。
