Departments of Medical Social Sciences, Surgery, and Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL.
Departments of Psychiatry, Psychology, Epidemiology, Biostatistics, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA.
Liver Transpl. 2018 Sep;24(9):1221-1232. doi: 10.1002/lt.25185.
Little is known about living liver donors' perceptions of their physical well-being following the procedure. We collected data on donor fatigue, pain, and other relevant physical outcomes as part of the prospective, multicenter Adult-to-Adult Living Donor Liver Transplantation Cohort Study consortium. A total of 271 (91%) of 297 eligible donors were interviewed at least once before donation and 3, 6, 12, and 24 months after donation using validated measures when available. Repeated measures regression models were used to identify potential predictors of worse physical outcomes. We found that donors reported more fatigue immediately after surgery that improved by 2 years after donation, but not to predonation levels. A similar pattern was seen across a number of other physical outcomes. Abdominal or back pain and interference from their pain were rated relatively low on average at all study points. However, 21% of donors did report clinically significant pain at some point during postdonation study follow-up. Across multiple outcomes, female donors, donors whose recipients died, donors with longer hospital stays after surgery, and those whose families discouraged donation were at risk for worse physical well-being outcomes. In conclusion, although not readily modifiable, we have identified risk factors that may help identify donors at risk for worse physical outcomes for targeted intervention. Liver Transplantation 00 000-000 2018 AASLD.
关于活体肝移植供体在手术后对其身体健康的认知，目前知之甚少。我们收集了供体疲劳、疼痛和其他相关身体结果的数据，作为前瞻性、多中心成人对成人活体肝移植供体移植队列研究联盟的一部分。共有 297 名符合条件的供体中的 271 名（91%）在捐赠前至少接受了一次采访，并在捐赠后 3、6、12 和 24 个月使用可用的验证措施进行了采访。重复测量回归模型用于确定身体结果恶化的潜在预测因素。我们发现，供体在手术后立即报告疲劳感更严重，但在捐赠后 2 年内有所改善，但并未恢复到捐赠前的水平。其他一些身体结果也呈现出类似的模式。腹部或背部疼痛以及疼痛对他们的干扰在所有研究点的平均水平相对较低。然而，21%的供体在捐赠后研究随访期间的某个时候确实报告了有临床意义的疼痛。在多个结果中，女性供体、受体死亡的供体、手术后住院时间较长的供体以及其家庭劝阻捐赠的供体，身体幸福感较差的风险更高。总之，尽管不易改变，但我们已经确定了一些风险因素，这些因素可能有助于确定身体结果较差的供体，以便进行有针对性的干预。肝脏移植 00000-00000 2018 AASLD。
