Psychiatric and surgical outcome in egyptian donors after living-donor liver transplantation

Abstract

©2016 Institute of Psychiatry, Ain Shams University. Introduction Living-donor liver transplantation has emerged as a life-saving alternative for those with end-stage liver disease. However, surgical complications may lead to physical, mental, and psychosocial complications that could affect the quality of life and psychological outcomes of living donors after transplantation. Aim The aim of the study was to assess the satisfaction of donors with the decision to donate and their willingness to donate again and its relation with postoperative complications, and consequently the effect on psychiatric morbidity and quality of life of the donors. Patients and methods The present study evaluated 33 donor candidates who were introduced to donation after being subjected to all medical and psychological tests, which were free of cost. All participants were interviewed using a questionnaire on personal history, relationship to recipient, and satisfaction with donation, a General Health Questionnaire, the SCID-I, Beck Depression Inventory, the Taylor Manifest Anxiety Scale, the PCASEE Quality of Life Questionnaire, and the Clavien classification for surgical complications. Results Among donors 33% reported that they would donate again. One week after surgery, 6% had grade 2 and 6% had grade 3a complications; 3 months postoperatively, 3% had grade 2 and 3% had grade 3a complications. Psychiatric morbidity was 15% (6% anxiety disorders, 6% major depression, and 3% adjustment disorder). No relation was found between quality of life and postoperative complications, whereas depression and anxiety were highly correlated. Conclusion Surgeons and psychiatrists have to work together to select donors, provide assistance in decision making, and minimize any postoperative complications either surgically or psychiatrically.