Right hepatic lobe donation for living donor liver transplantation: Impacton donor quality of life

Adult right hepatic lobe living donor liver transplantation (LDLT) has rapi dly gained widespread acceptance as an effective procedure for selected pat ients with end-stage liver disease. However, there are currently no publish ed data on the effect of this procedure on the quality of life of donors. W e report the results of a survey of our living liver transplant donors to d etermine the effect of right hepatic lobe donation on quality of life, We h ave performed 30 LDLTs since 1997; 24 of these have a follow-up of 4 months or longer. In August 2000, these patients were sent a questionnaire (inclu ding a Medical Outcomes Study 36-Item Short-Form Survey) regarding psychoso cial outcomes and symptoms after surgery. Major complications occurred in 4 of 24 patients (16%), and minor complications, in 4 of 24 patients (16%). Complete recovery occurred in 75% of patients at a mean time of 3.4 months. Ninety-six percent of patients returned to the same predonation job after a mean time of 2.4 months, and 66% of patients required a period of light-d uty work for a mean of 2.8 months before returning to full-duty work. A cha nge in body image was reported in 42% of patients, and 71% reported mild on going symptoms (primarily abdominal discomfort) that they related to the do nor surgery for which 29% sought evaluation by a physician. The donor's rel ationship with the recipient was the same or better in 96% of donors, and t he relationship with the donor's significant other was the same or better i n 88% of donors, Mean out-of-pocket expenses incurred by donors were $3,660 . Sixty-three percent of donors reported experiencing more pain than antici pated. All patients would donate again if necessary, and 96% benefited from the donor experience. In conclusion, (1) all our donors are alive and well after donation; (2) almost all donors were able to return to predonation e mployment status within a few months; (3) most donors have mild persistent abdominal symptoms, and some donors had a change in body image that they at tribute to the donor surgery; and (4) this information should be provided t o potential donors so they may better understand the impact of donor surger y.