Long-term follow-up after right hepatectomy for adult living donation and attitudes toward the procedure.
Ann Surg
; 254(5): 694-700; discussion 700-1, 2011 Nov.
Article
em En
| MEDLINE
| ID: mdl-22005145
ABSTRACT
OBJECTIVES:
To determine the long-term health status of donors after right hepatectomy for adult live donor liver transplantation (ALDLT).BACKGROUND:
The long-term outcomes for ALDLT donors are unknown.METHODS:
ALDLT donors undergoing right hepatectomy from April 1998 to June 2007 were invited to complete a questionnaire regarding health status, satisfaction (1-10/worst-best scale), self-esteem, willingness to donate again, and suggestions for improvement. In addition, donor files and cholecystectomy specimens were reviewed. Fisher's exact test, Kaplan-Meier and logistic regression analyses were performed.RESULTS:
Eighty-three donors were contacted (median age 36 years; median follow-up 69 months). 39 (47%) were free of symptoms. The remaining 44 (53%) reported intolerance to fatty meals and diarrhea (31%), gastroesophageal reflux associated with left liver hypertrophy (9%), incisional discomfort requiring pain medications (6%), severe depression requiring hospitalization (4%), rib pain affecting lifestyle (2%), and exacerbation of psoriasis (1%). Median satisfaction score was 8. Self-esteem diminished in 5%. Thirty-nine (47%) recommended improvements particularly more detailed informed donor consent and a centralized living donor liver registry. Seventy-eight (94%) were willing to donate again. There were no differences between donors with and without complaints with respect to donor age, gender, early complications and follow-up time, young-to-old donation, recipient diagnosis of malignancy and death of the recipient. Noninflamed donor cholecystectomy specimens correlated with intolerance to fatty meals and diarrhea (P = 0.001).CONCLUSIONS:
ALDLT donors are at risk for long-term complaints that are neither reflected nor related to early complications. This information should be included in both the donor evaluation and the ALDLT decision-making process.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transplante de Fígado
/
Doadores Vivos
/
Hepatectomia
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article