Kousoulas L, Emmanouilidis N, Klempnauer J, Lehner F
Department of General, Visceral, and Transplant Surgery, Hanover Medical School, Hanover, Germany.
Transplant Proc. 2011 Dec;43(10):3584-7. doi: 10.1016/j.transproceed.2011.10.038.
The aim of this study was to evaluate the health-related quality of life of living liver donors after living-donor liver transplantation (LDLT).
Health-related quality of life (HRQOL) in 55 living liver donors operated on at our center between 2002 and 2009 was assessed using the German Version of the 36-Item Health Survey (SF-36).
Donors after full right-lobe hepatectomy (n=18) scored similarly to and without statistically significant difference from the German reference population, whereas donors after left lateral segmentectomy (n=37) revealed statistically significant higher average score values (P<.005) in the categories of physical functioning, bodily pain, and general health compared with the German reference population. In the analysis between donors after full right-lobe hepatectomy and donors after left lateral segmentectomy no statistically significant difference was observed in any of the SF-36 categories. Postoperative complications of the donors and postoperative recipient mortality were particularly revealing regarding HRQOL. Donors who developed postoperative complications presented a lower HRQOL, especially in the categories of role physical, bodily pain, and social functioning, where statistically significant differences (P<.005) were observed. Similarly, postoperative recipient mortality correlated with lower mean score values in all SF-36 categories, but a statistically significant difference (P<.005) was reached only in the categories of role emotional and mental health.
Donors did not regret their decision to donate, because HRQOL was not negatively affected by the donation procedure. Living liver donors scored as well as or even better than the German reference population, but it was clearly shown that the development of postoperative donor complications and the postoperative recipient mortality had a negative effect on the HRQOL of donors.
本研究旨在评估活体肝移植(LDLT)后活体肝供者的健康相关生活质量。
采用德国版36项健康调查量表(SF-36)对2002年至2009年在本中心接受手术的55例活体肝供者的健康相关生活质量进行评估。
全右叶肝切除术后的供者(n=18)得分与德国参考人群相似,无统计学显著差异;而左外叶肝切除术后的供者(n=37)在身体功能、身体疼痛和总体健康方面的平均得分值与德国参考人群相比有统计学显著升高(P<0.005)。在全右叶肝切除术后的供者与左外叶肝切除术后的供者之间的分析中,SF-36各维度均未观察到统计学显著差异。供者的术后并发症和受者术后死亡率对健康相关生活质量的影响尤为明显。发生术后并发症的供者健康相关生活质量较低,尤其是在角色身体、身体疼痛和社会功能方面,差异有统计学意义(P<0.005)。同样,受者术后死亡率与SF-36所有维度的平均得分值较低相关,但仅在角色情感和心理健康维度差异有统计学意义(P<0.005)。
供者并不后悔他们的捐赠决定,因为捐赠过程并未对健康相关生活质量产生负面影响。活体肝供者的得分与德国参考人群相当甚至更好,但明显显示供者术后并发症的发生和受者术后死亡率对供者的健康相关生活质量有负面影响。