Erim Yesim, Beckmann Mingo, Kroencke Sylvia, Valentin-Gamazo Camino, Malago Massimo, Broering Dieter, Rogiers Xavier, Frilling Andrea, Broelsch Christoph E, Schulz Karl-Heinz
Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Essen, Essen, Germany.
Liver Transpl. 2007 Jun;13(6):886-95. doi: 10.1002/lt.21168.
The ethical soundness of living donor liver transplantation (LDLT) in urgent indications is still under discussion. The aim of the survey was to investigate the psychological distress of donors in cases of hepatocellular carcinoma (HCC) or acute liver failure (ALF). In a prospective multicenter study (n = 123), health-related quality of life (QOL), anxiety, and depression were measured. The psychological distress of donors was correlated to the degree of urgency of the recipients' indication, which was classified as nonurgent, HCC, or ALF. During the donor evaluation prior to LDLT, the donors with recipients for HCC and ALF demonstrated significantly reduced mental QOL in comparison to donors for a nonurgent indication and to the German normative sample. Compared to healthy controls, anxiety and depression were significantly increased in donors for ALF. Three months after the transplantation, scores for mental QOL as well as for anxiety and depression improved and were within the normal range for the whole group as well as for the ALF donors. In conclusion, the psychological burden was temporary in nature. Our findings can be considered as arguments for the current practice to address family members as donors in cases of HCC and ALF.
活体供肝肝移植（LDLT）在紧急情况下的伦理合理性仍在讨论之中。该调查的目的是研究肝细胞癌（HCC）或急性肝衰竭（ALF）病例中供体的心理困扰。在一项前瞻性多中心研究（n = 123）中，对与健康相关的生活质量（QOL）、焦虑和抑郁进行了测量。供体的心理困扰与受者病情的紧急程度相关，后者被分类为非紧急、HCC或ALF。在LDLT之前的供体评估期间，与非紧急情况的受者的供体以及德国正常样本相比，HCC和ALF受者的供体表现出显著降低的心理QOL。与健康对照组相比，ALF供体的焦虑和抑郁显著增加。移植后三个月，心理QOL以及焦虑和抑郁得分有所改善，并且在整个组以及ALF供体中都处于正常范围内。总之，心理负担本质上是暂时的。我们的研究结果可被视为支持当前在HCC和ALF病例中让家庭成员作为供体的做法的论据。
