Daniela P Ladner1, Mary Amanda Dew2, Sarah Forney3, Brenda W Gillespie4, Robert S Brown5, Robert M Merion6, Chris E Freise7, Paul H Hayashi8, Johnny C Hong9, April Ashworth10, Carl L Berg11, James R Burton12, Abraham Shaked13, Zeeshan Butt14. 1. Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL, USA. Electronic address: dladner@nmh.org. 2. Departments of Psychiatry, Psychology, Epidemiology and Biostatistics, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, PA, USA. 3. Arbor Research Collaborative for Health, Ann Arbor, MI, USA. 4. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA. 5. Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA. 6. Arbor Research Collaborative for Health, Ann Arbor, MI, USA; Department of Surgery, University of Michigan, Ann Arbor, MI, USA. 7. Department of Surgery, University of California, San Francisco, San Francisco, CA, USA. 8. Department of Medicine, University of North Carolina, Chapel Hill, NC, USA. 9. Department of Surgery, Medical College of Wisconsin, WI, USA. 10. Virginia Commonwealth University, Richmond, VA, USA. 11. Duke University Health System, Durham, NC, USA. 12. Department of Medicine, University of Colorado, Aurora, CO, USA. 13. Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA. 14. Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Abstract
BACKGROUND & AIMS: There are few long-term studies of the health-related quality of life (HRQOL) in living liver donors. This study aimed to characterize donor HRQOL in the Adult to Adult Living Donor Liver Transplantation Study (A2ALL) up to 11 years post-donation. METHODS: Between 2004 and 2013, HRQOL was assessed at evaluation, at 3 months, and yearly post-donation in prevalent liver donors using the short-form survey (SF-36), which provides a physical (PCS) and a mental component summary (MCS). RESULTS: Of the 458 donors enrolled in A2ALL, 374 (82%) had SF-36 data. Mean age at evaluation was 38 (range 18-63), 47% were male, 93% white, and 43% had a bachelor's degree or higher. MCS and PCS means were above the US population at all time points. However, at every time point there were some donors who reported poor scores (>1/2 standard deviation below the age and sex adjusted mean) (PCS: 5.3-26.8%, MCS: 10.0-25.0%). Predictors of poor PCS and MCS scores included recipient's death within the two years prior to the survey and education less than a bachelor's degree; poor PCS scores were also predicted by time since donation, Hispanic ethnicity, and at the 3-month post-donation time point. CONCLUSIONS: In summary, most living donors maintain above average HRQOL up to 11 years prospectively, supporting the notion that living donation does not negatively affect HRQOL. However, targeted support for donors at risk for poor HRQOL may improve overall HRQOL outcomes for living liver donors.
BACKGROUND & AIMS: There are few long-term studies of the health-related quality of life (HRQOL) in living liver donors. This study aimed to characterize donor HRQOL in the Adult to Adult Living Donor Liver Transplantation Study (A2ALL) up to 11 years post-donation. METHODS: Between 2004 and 2013, HRQOL was assessed at evaluation, at 3 months, and yearly post-donation in prevalent liver donors using the short-form survey (SF-36), which provides a physical (PCS) and a mental component summary (MCS). RESULTS: Of the 458 donors enrolled in A2ALL, 374 (82%) had SF-36 data. Mean age at evaluation was 38 (range 18-63), 47% were male, 93% white, and 43% had a bachelor's degree or higher. MCS and PCS means were above the US population at all time points. However, at every time point there were some donors who reported poor scores (>1/2 standard deviation below the age and sex adjusted mean) (PCS: 5.3-26.8%, MCS: 10.0-25.0%). Predictors of poor PCS and MCS scores included recipient's death within the two years prior to the survey and education less than a bachelor's degree; poor PCS scores were also predicted by time since donation, Hispanic ethnicity, and at the 3-month post-donation time point. CONCLUSIONS: In summary, most living donors maintain above average HRQOL up to 11 years prospectively, supporting the notion that living donation does not negatively affect HRQOL. However, targeted support for donors at risk for poor HRQOL may improve overall HRQOL outcomes for living liver donors.
Keywords:
Adult to adult living donor liver transplantation cohort study (A2ALL); Living donor liver transplantation; Living liver donors; Patient reported outcomes; Quality of life
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