Developing ‘Comorbid’ Conditions Post-transplant Reduces Donor Quality of Life
Researchers in Japan report that health-related
quality of life (HRQOL) for donors following living donor liver
transplantation (LDLT) was better than the general Japanese population
(the norm). This study—one of the largest to date—found that donors who
developed two or more medical problems (co-morbidities) after donation
had significantly decreased long-term HRQOL. Full findings are
published in the November issue of Liver Transplantation, a journal of the American Association for the Study of Liver Diseases (AASLD).
The shortage of viable donor organs continues to be a
critical issue for the transplant community. Livers, in particular,
are in short supply, with the Organ Procurement and Transplantation
Network (OPTN) reporting that in the U.S. more than 16,000 patients are
currently on the waiting list. To ease the shortage of deceased donor
organs, transplant specialists are turning to LDLT—a widely accepted
alternative approach, especially in Japan, where one study shows that
close to 6,000 of these procedures were performed by December 2008.
“With LDLTs being performed at increasing rates, it
is important to understand the long-term outcomes for living donors,”
explains lead study author Dr. Yasutsugu Takada with the Ehime
University Graduate School of Medicine in Japan. “Our study is the
largest to investigate living liver donors’ quality of life and to
determine potential risk factors following transplantation.”
The team contacted 997 living donors who provided a
piece of liver for transplantation, which were performed at Kyoto
University Hospital between 1990 and 2004. Researchers mailed the
36-item short-form health survey to all donors and 578 (58%) responded.
The survey responses are summarized by: the physical component summary,
mental component summary, and role/social components by component. A
norm-based scoring system was used to report survey results.
Findings indicate that norm-based HRQOL scores for
the 367 left- and 211 right-lobe donors were better than the Japanese
norm across all time periods. The median post-transplant follow-up
period was nearly 7 years. Further analysis determined that decreased
HRQOL scores, specifically lower mental health and social functioning,
were significantly associated with age of donor, persistence of
symptoms, emergence of additional diseases, or other consequences
(additional hospital visits, continued work absence) following donation.
Dr. Takada concludes, “Kyoto University Hospital is
one of the high volume transplant centers in Asia, as such, we are
keenly aware of the necessity and responsibility to report donor
long-term QOL. Our findings suggest that careful follow-up and
counseling are necessary for donors at risk for poor quality of life.”
In a related editorial, Drs. Leona Kim-Schluger
and Sander Florman from The Mount Sinai Medical Center in New York
highlight that the importance of the Takada et al study is the sheer
size of the living donor cohort and the long-term follow-up of donors to
evaluate HRQOL. They write, “We must strive to study and comprehend
the motivations leading to donation, the financial and economic impact
of donation, and learn to alleviate the fears pre and post donation,
with the one goal of safely getting the living donors through the donor
process medically, surgically, and psychologically.”
Full citations: “Long-Term Quality of Life of
Donors After Living Donor Liver Transplantation.” Yasutsugu Takada,
Yoshimi Suzukamo, Fumitaka Oike, Hiroto Egawa, Satoshi Morita, Shunichi
Fukuhara, Shinji Uemoto and Koichi Tanaka. Liver Transplantation; (DOI: 10.1002/lt.23509) Print Issue Date: November, 2012.
Editorial: “Quality of Life After Living Donor Liver
Transplant: What Have We Learned and How Can We Do Better.” Leona
Kim-Schluger and Sander Florman. Liver Transplantation; (DOI: 10.1002/lt.23528) Print Issue Date: November, 2012. .
About the Author: To arrange an interview with Dr. Takada please contact the press office at Kyoto University Hospital firstname.lastname@example.org. Media wishing to speak with Drs. Kim-Schluger or Florman may contact Kevin Orozovich at Kevin.Orozovich@mountsinai.org.
About the Journal:
Liver Transplantation is published by Wiley on behalf of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.
Since the first application of liver transplantation in a clinical
situation was reported more than twenty years ago, there has been a
great deal of growth in this field and more is anticipated. As an
official publication of the AASLD and the ILTS,
Liver Transplantation delivers current, peer-reviewed articles on
surgical techniques, clinical investigations and drug research — the
information necessary to keep abreast of this evolving specialty. For
more information, please visit http://wileyonlinelibrary.com/journal/livertransplantation
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