Donor postoperative outcome and quality of life after living donor liver transplantation

J. van Son, G.J.A. Hegeman, F.M. Heikamp, H.J.L. Quaedvlieg, J.H. Annema, M.T. de Boer

Wednesday 13 march 2019

14:24 - 14:26h at Koningin Máximazaal

Categories: Basaal, Parallelsessie

Parallel session: Parallelsessie III - Basaal I

Background: Living donor liver transplantation (LDLT) is a life-saving procedure for pediatric patients with end stage liver disease. However, living donors are put at risk and studies on the long-term complications and health related quality of life (HRQoL) for living donors after left lateral sectionectomy (LLS) are limited. In this study we aim to describe the postoperative complications, to compare the HRQoL of LDLT donors with the general population and with living donor kidney transplantation (LDKT) donors.

Methods: 45 LDLT donors were included. Complications were prospectively documented in a database. Comprehensive Complication Index (CCI) was calculated. A questionnaire consisting of RAND-36, PGWBI and Carolina’s Comfort Scale (CCS) was sent to the donors. Results were compared to the general population and LDKT donors.

Results: Common problems after LDLT were excessive postoperative pain (20.0%) and cardiopulmonary complications (15.6%), although grade 3 complications according to Clavien Dindo were seldom seen (n=2, 5.4%). Median CCI was 0 (IQR 0-12.2). Response rate to the questionnaire was 44%. On the RAND-36, LDLT donors scored higher on physical functioning than LDKT donors (P< 0.001) and higher than general population (P = 0.012). On social functioning LDLT donors scored lower than the general population (P = 0.046). On role limitations emotional problems (P = 0.004), mental health (P = 0.008) and vitality (P = 0.032) LDLT donors scored lower than LDKT donors. On the PGWBI, no significant differences were found. On the CCS, LDLT donors had more movement limitations when coughing or deep breathing (P= 0.041) than LDKT donors.

Conclusions: Major complications are rare after LLS liver donation. Although physically the LDLT procedure does not seem to impair HRQoL, negative effects were seen on psychological domains. Furthermore liver donors showed more movement limitations after surgery when compared to kidney donors, which can probably be explained by the extent of the operation. Future studies after the implementation of our long-term HRQoL program in LDLT and LDKT donors are required to make reliable comparisons between groups possible.