Wang Szu-Han, Lin Ping-Yi, Wang Jiun-Yi, Huang Mei-Feng, Lin Hui-Chuan, Hsieh Chia-En, Hsu Ya-Lan, Chen Yao-Li
Organ Transplant Center Transplant Medicine & Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan Department of Medical Research, China Medical University Hospital Department of Health Care Administration, Asia University Department of Nursing, China Medical University Hospital Department of Senior Citizen Welfare and Business, Hungkuang University, Taichung, Taiwan Transplantation Center, Third Xiangya Hospital of Central South University, Changsha, China Department of General Surgery, Changhua Christian Hospital, Changhua School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Medicine (Baltimore). 2017 May;96(19):e6910. doi: 10.1097/MD.0000000000006910.
Donor safety and preservation of donor health after living liver donation are of paramount importance. In addition, the preoperative mental state of a donor is an important factor in determining the psychological impact of donor hepatectomy. Thus, we aimed to explore the mental health status of living liver donors after hepatectomy. We enrolled 60 donors who were scheduled to undergo living donor hepatectomy during the period January 2014 to March 2015 at a single medical center. Mental health status was measured before and 3 months after surgery using 3 self-report questionnaires, namely the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms, the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire to measure quality of life, and the Chinese Health Questionnaire (CHQ) to screen for minor psychiatric disorders. A comparison of the pre- and postdonation CES-D scores revealed a significant reduction in depressive symptoms after surgery (P = .031). There were significant improvements in the physical health domain (P = .031), the psychological health domain (P = .005), the social relationships domain (P = .005), and the environmental health domain (P = .010) of the WHOQOL-BREF. There were no significant changes in CHQ scores after donor hepatectomy (P = .136). All donors reported that they would donate again if required. Approximately one-third (33.3%) of donors experienced more pain than they had anticipated in the immediate postoperative period, and 20.0% of donors had complications after donor hepatectomy. Donor mental health status tended to improve as donors regained physical function during the 1st 3 months of recovery. Long-term monitoring of living donors' mental health is needed to minimize the adverse psychological outcomes of living liver donation.
活体肝移植供体的安全及供体健康的维护至关重要。此外，供体的术前心理状态是决定供体肝切除心理影响的重要因素。因此，我们旨在探讨肝切除术后活体肝移植供体的心理健康状况。我们纳入了60例计划于2014年1月至2015年3月在单一医疗中心接受活体供肝肝切除术的供体。使用3份自评问卷在手术前及术后3个月测量心理健康状况，即流行病学研究中心抑郁量表（CES-D）评估抑郁症状、世界卫生组织生活质量问卷（WHOQOL-BREF）测量生活质量、以及中文健康问卷（CHQ）筛查轻度精神障碍。供体前后CES-D评分比较显示术后抑郁症状显著减轻（P = 0.031）。WHOQOL-BREF的身体健康领域（P = 0.031）、心理健康领域（P = 0.005）、社会关系领域（P = 0.005）及环境健康领域（P = 0.010）均有显著改善。供体肝切除术后CHQ评分无显著变化（P = 0.136）。所有供体均表示如有需要愿意再次捐献。约三分之一（33.3%）的供体在术后即刻经历了比预期更多的疼痛，20.0%的供体在供体肝切除术后出现并发症。在恢复的前3个月，随着供体身体功能的恢复，供体心理健康状况趋于改善。需要对活体供体的心理健康进行长期监测，以尽量减少活体肝移植的不良心理后果。
