Mary Amanda Dew1,2,3,4, Zeeshan Butt5,6,7, Qian Liu8, Mary Ann Simpson9,10, Jarcy Zee8, Daniela P Ladner5,6, Susan Holtzman11, Abigail R Smith8, Elizabeth A Pomfret10, Robert M Merion8,12, Brenda W Gillespie13, Averell H Sherker14, Robert A Fisher15, Kim M Olthoff16, James R Burton17, Norah A Terrault18, Alyson N Fox18, Andrea F DiMartini1,19. 1. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA. 2. Department of Psychology, University of Pittsburgh, Pittsburgh, PA. 3. Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA. 4. Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA. 5. Northwestern University Transplant Outcomes Research Collaborative (NUTORC) Chicago, IL. 6. Comprehensive Transplant Center, Northwestern University, Chicago, IL. 7. Departments of Medical Social Sciences and Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL. 8. Arbor Research Collaborative for Health, Ann Arbor, MI. 9. Lahey Hospital and Medical Center Clinical Research and Education Burlington, MA. 10. Department of Transplantation, Lahey Hospital and Medical Center, Burlington, MA. 11. Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada. 12. Department of Surgery, University of Michigan, Ann Arbor, MI. 13. Department of Biostatistics, University of Michigan, Ann Arbor, MI. 14. Liver Diseases Research Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. 15. Department of Transplant Surgery, Virginia Commonwealth University, Richmond, VA. 16. Department of Surgery, University of Pennsylvania, Philadelphia, PA. 17. Division of Gastroenterology/Hepatology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO. 18. Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, NY. 19. Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Abstract
BACKGROUND: Prospective and longitudinal studies have examined liver donors' medical outcomes beyond the first 1 to 2 years postdonation. There is no analogous longitudinal evidence on long-term psychosocial outcomes, including patient-reported clinically significant mental health problems and perceptions of physical well-being. We examined prevalence, descriptive characteristics, and predictors of diagnosable mental health conditions and self-reported physical health problems, including fatigue and pain, in the long-term years after liver donation. METHODS: Donors from 9 centers who initially completed telephone interviews at 3 to 10 years postdonation (mean, 5.8 years; SD, 1.9) were reinterviewed annually for 2 years using validated measures. Outcomes were examined descriptively. Repeated-measures regression analyses evaluated potential predictors and correlates of outcomes. RESULTS: Of 517 donors initially interviewed (66% of those eligible), 424 (82%) were reassessed at least once. Prevalence rates of major depression and clinically significant pain were similar to general population norms; average fatigue levels were better than norms. All prevalence rates showed little temporal change. Anxiety and alcohol use disorder rates exceeded normative rates at 1 or more assessments. Longer postdonation hospitalization, female sex, higher body mass index, concerns about donation-related health effects, and burdensome donation-related financial costs were associated with increased risk for most outcomes (P's < 0.05). Men were at higher risk for alcohol use disorder (P < 0.001). CONCLUSIONS: Anxiety and alcohol use disorders were more common than would be expected; they may warrant increased research attention and clinical surveillance. Surveillance for long-term problems in the areas assessed may be optimized by targeting donors at higher risk based on identified predictors and correlates.
BACKGROUND: Prospective and longitudinal studies have examined liver donors' medical outcomes beyond the first 1 to 2 years postdonation. There is no analogous longitudinal evidence on long-term psychosocial outcomes, including patient-reported clinically significant mental health problems and perceptions of physical well-being. We examined prevalence, descriptive characteristics, and predictors of diagnosable mental health conditions and self-reported physical health problems, including fatigue and pain, in the long-term years after liver donation. METHODS: Donors from 9 centers who initially completed telephone interviews at 3 to 10 years postdonation (mean, 5.8 years; SD, 1.9) were reinterviewed annually for 2 years using validated measures. Outcomes were examined descriptively. Repeated-measures regression analyses evaluated potential predictors and correlates of outcomes. RESULTS: Of 517 donors initially interviewed (66% of those eligible), 424 (82%) were reassessed at least once. Prevalence rates of major depression and clinically significant pain were similar to general population norms; average fatigue levels were better than norms. All prevalence rates showed little temporal change. Anxiety and alcohol use disorder rates exceeded normative rates at 1 or more assessments. Longer postdonation hospitalization, female sex, higher body mass index, concerns about donation-related health effects, and burdensome donation-related financial costs were associated with increased risk for most outcomes (P's < 0.05). Men were at higher risk for alcohol use disorder (P < 0.001). CONCLUSIONS:Anxiety and alcohol use disorders were more common than would be expected; they may warrant increased research attention and clinical surveillance. Surveillance for long-term problems in the areas assessed may be optimized by targeting donors at higher risk based on identified predictors and correlates.
Authors: C R Gross; E E Messersmith; B A Hong; S G Jowsey; C Jacobs; B W Gillespie; S J Taler; A J Matas; A Leichtman; R M Merion; H N Ibrahim Journal: Am J Transplant Date: 2013-09-06 Impact factor: 8.086
Authors: A DiMartini; R J Cruz; M A Dew; M G Fitzgerald; L Chiappetta; L Myaskovsky; M E DeVera Journal: Am J Transplant Date: 2011-11-14 Impact factor: 8.086
Authors: M M Abecassis; R A Fisher; K M Olthoff; C E Freise; D R Rodrigo; B Samstein; I Kam; R M Merion Journal: Am J Transplant Date: 2012-02-15 Impact factor: 8.086
Authors: Z Butt; M A Dew; Q Liu; M A Simpson; A R Smith; J Zee; B W Gillespie; S E Abbey; D P Ladner; R Weinrieb; R A Fisher; S Hafliger; N Terrault; J Burton; A H Sherker; A DiMartini Journal: Am J Transplant Date: 2017-01-03 Impact factor: 8.086
Authors: Marit Helen Andersen; Fanny Bruserud; Lars Mathisen; Astrid Klopstad Wahl; Berit Rokne Hanestad; Erik Fosse Journal: Clin Transplant Date: 2007 Nov-Dec Impact factor: 2.863
Authors: Zeeshan Butt; Andrea F DiMartini; Qian Liu; Mary Ann Simpson; Abigail R Smith; Jarcy Zee; Brenda W Gillespie; Susan Holtzman; Daniela Ladner; Kim Olthoff; Robert A Fisher; Silvia Hafliger; Chris E Freise; Mercedes Susan Mandell; Averell H Sherker; Mary Amanda Dew Journal: Liver Transpl Date: 2018-09 Impact factor: 5.799