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Prevalence and Predictors of Patient-Reported Long-Term Mental and Physical Health After Donation in the Adult to Adult Living Donor Liver Transplantation Cohort Study (A2ALL).

Transplantation; 2017 Sep 06.
Article in English | MEDLINE | ID: mdl-28885494

BACKGROUND:

Prospective and longitudinal studies have examined liver donors' medical outcomes beyond the first 1-2 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 3-10 years postdonation (M=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 like general population norms; average fatigue levels were better than norms. All donors 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 (BMI), concerns about donation-related health effects, and burdensome donation-related financial costs were associated with increased risk for most outcomes (p's<.05). Men were at higher risk for alcohol use disorder (p<.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.