Walter Marc, Papachristou Christina, Pascher Andreas, Danzer Gerhard, Neuhaus Peter, Klapp Burghard F, Frommer Jörg
Department of Internal Medicine/Psychosomatics, Charité- University Medicine Berlin, Berlin, and Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke University Hospital, Madgeburg, Germany.
Clin Transplant. 2006 Jul-Aug;20(4):410-5. doi: 10.1111/j.1399-0012.2006.00464.x.
Adult-to-adult living donor liver transplantation (LDLT) of the right hepatic lobe has been developing into an established therapy for treating pre-terminal liver diseases. There is little experience available on the psychosocial outcome of living donors. The aim of this first qualitative case study was to investigate the patterns for impaired psychosocial outcome in donors after LDLT. Donor hepatectomies were performed in 30 donors at the Charité Berlin. Six months after surgery, the six of the 30 donors with negative moods and physical complaints in psychometric monitoring were examined. The post-operative interviews were transcribed and analysed using current qualitative research methods. These six donors (20%) reported various unspecific complaints and psychological conflicts. Sadness was expressed about organ rejection and death of the recipient. Anxieties about the recipient and their own health were verbalized. Disappointment and anger refer to the experience that they were not as fully appreciated by the medical system and their social environment as expected. The negative emotions of donors with impaired psychosocial outcome could be related to a decrease in self-esteem in the post-operative course. Adequate medical and psychological treatment opportunities for these donors should be provided.
成人对成人右肝叶活体肝移植(LDLT)已发展成为治疗终末期肝病的一种成熟疗法。关于活体供者心理社会结局的经验很少。这项首个定性案例研究的目的是调查活体肝移植后供者心理社会结局受损的模式。柏林夏里特医院对30名供者进行了供肝切除术。术后6个月,对30名在心理测量监测中有负面情绪和身体不适的供者中的6名进行了检查。使用当前的定性研究方法对术后访谈进行了转录和分析。这6名供者(20%)报告了各种非特异性不适和心理冲突。对受者的器官排斥和死亡表达了悲伤。表达了对受者及其自身健康的焦虑。失望和愤怒是指他们没有像预期的那样得到医疗系统和社会环境充分认可的经历。心理社会结局受损的供者的负面情绪可能与术后过程中自尊的下降有关。应为这些供者提供充分的医疗和心理治疗机会。