Keck School of Medicine, University of Southern California, Los Angeles, California.
Keck School of Medicine, University of Southern California, Los Angeles, California; Division of Hepatobiliary and Abdominal Transplant Surgery, Department of Surgery, University of Southern California, Los Angeles, California.
J Surg Res. 2020 Sep;253:41-52. doi: 10.1016/j.jss.2020.03.025. Epub 2020 Apr 19.
To assess the impact of living liver donation (LD) in a diverse and aging population up to 20 y after donation, particularly with regard to medical, financial, psychosocial, and overall health-related quality of life (HRQOL).
Patients undergoing LD between 1999 and 2009 were recruited to respond to the Short-Form 36 and a novel Donor Quality of Life Survey at two time points (2010 and 2018).
Sixty-eight living liver donors (LLDs) completed validated surveys, with a mean follow-up of 11.5 ± 5.1 y. Per Donor Quality of Life Survey data, physical activity or strength was not impacted by LD in most patients. All respondents returned to school or employment, and 82.4% reported that LD had no impact on school or work performance. LD did not impact health insurability in 95.6% of donors, and only one patient experienced difficulty obtaining life insurance. Overall, 97.1% of respondents did not regret LD. Short-Form 36 survey-measured outcomes were similar between LLDs and the general U.S.
LLDs who responded in both 2010 and 2018 were followed for an overall average of 15.4 ± 2.4 y and HRQOL outcomes in these donors also remained statistically equivalent to U.S. population norms.
This study represents the longest postdonation follow-up and offers unique insight related to HRQOL in a highly diverse patient population. Although LLDs continue to maintain excellent HRQOL outcomes up to 20 y after donation, continued lifetime follow-up is required to accurately provide young, healthy potential donors with an accurate description of the risks that they may incur on aging.
评估在多样化和老龄化的人群中进行活体肝移植（LD）的影响，时间跨度长达捐赠后 20 年，尤其关注医疗、经济、心理社会和整体健康相关生活质量（HRQOL）。
招募于 1999 年至 2009 年期间接受 LD 的患者，在两个时间点（2010 年和 2018 年）分别使用简明 36 项健康调查量表（Short-Form 36）和新的供者生活质量调查（Donor Quality of Life Survey）进行问卷调查。
68 名活体肝供者（LLD）完成了有效的问卷调查，平均随访时间为 11.5±5.1 年。根据供者生活质量调查数据，大多数患者的体力活动或力量并未受到 LD 的影响。所有受访者均重返学校或工作，82.4%的人表示 LD 对其学习或工作表现没有影响。LD 并未影响 95.6%供者的医疗保险，仅 1 名患者在获得寿险方面存在困难。总体而言，97.1%的受访者不后悔 LD。LLD 在简明 36 项健康调查量表测量的结果与美国一般人群相似。
这项研究代表了最长的随访时间，为高度多样化的患者人群提供了与 HRQOL 相关的独特见解。尽管 LLD 在捐赠后 20 年内继续保持良好的 HRQOL 结果，但仍需要进行终身随访，以准确向年轻、健康的潜在供者描述他们在年老时可能面临的风险。
