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Living-Donor Liver Transplant in Oman: A Quantitative Cross-Sectional Study of Donors' Experiences and Challenges. J Transplant 2021; 2021:4251814. [PMID: 34820137 PMCID: PMC8608518 DOI: 10.1155/2021/4251814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background In Oman, the first liver transplant was performed at the Royal Hospital (RH) in September 2017. Since then, thirteen cases have been operated on at the RH. All of these cases were living-donor liver transplants (LDLT), and the remaining cases were treated in India with a total of approximately 193 recipients. To provide an in-depth overview of donor experiences, challenges, and perceptions, a cross-sectional study was conducted. Methods A cross-sectional study was conducted at one tertiary hospital in 2019. The survey was designed to collect data composed of closed and open-ended questions to reveal a thorough knowledge of the topic. Results A total of 50 of 120 donors responded to the survey with male dominance in the sample (68%) and 64% were aged 28 to 38 years. 66% of the respondents came to know about the donation through hospital staff. Interestingly, respondents (n = 8/12) who reported that fear of operation is the cause that prevents people from donating are among the male gender, while more men believe that the main cause is lack of knowledge. 90% of the respondents felt satisfied after donation. More men reported ambiguous feelings before donation. Moreover, married donors reported ambiguous feelings before donation (p = 0.008). The younger age group reported anxiety and doubt as a challenge through their donation experience. Conclusion This study revealed that donors have a positive feeling after donating as they have saved a life, as well as being empowered by family and community. The donors encourage individuals to donate a portion of their liver. Some crucial questions arose, such as anxiety before surgery, ambiguous feelings before surgery, and fatigue after surgery. These findings underscore the importance of a holistic approach that would enable donors to be well informed prior to surgery.
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Krespi MR, Tankurt A, Acarli K, Kanmaz T, Yankol Y, Kalayoglu M. Beliefs of Living Donors About Recipients' End-Stage Liver Failure and Surgery for Organ Donation. Transplant Proc 2017; 49:1369-1375. [PMID: 28736009 DOI: 10.1016/j.transproceed.2017.02.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/26/2017] [Accepted: 02/07/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The concept of beliefs could provide a basis for how donors may perceive recipients' end-stage liver failure (ESLF) and surgery for organ donation. However, there is no such quantitative study. Therefore, the objective of this study was to explore beliefs of living donors about recipients' ESLF and surgery for organ donation. METHODS The sample comprised 16 living donors who donated a part of their liver to a patient who had ESLF. The data were analyzed by following established procedures for inductive qualitative analysis. RESULTS Analysis showed that donors' beliefs can be viewed in a number of groups. Beliefs about recipients' ESLF included diverse explanations for ESLF (blaming oneself and physicians) and physical symptoms (developmental slowing down). Beliefs about being a donor included reasons for being a donor (performing a good deed, being healed), barriers to being a donor (other people being ignorant and selfish), ways to manage these barriers (following one's gut feeling), and factors facilitating being a donor (the feeling that one does not have many people to leave behind). Beliefs about surgery for organ donation included physical effects (pain, feeling stiff). Beliefs about organ donation included views that general organ donation should be encouraged and that people's awareness should be raised. CONCLUSIONS Existing psychological perspectives could help to interpret some beliefs. Nevertheless, other beliefs, not previously reported, could be considered as targets for individual consultations/psycho-educational programs for fostering emotional well-being.
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Affiliation(s)
- M R Krespi
- Department of Psychology, Kadir Has University, Istanbul, Turkey.
| | - A Tankurt
- Department of Child and Adolescent Mental Health, Bezmialem Foundation Trust University, Istanbul, Turkey
| | - K Acarli
- Memorial Sisli Hospital, Centre of Organ Transplantation, Istanbul, Turkey
| | - T Kanmaz
- Memorial Sisli Hospital, Centre of Organ Transplantation, Istanbul, Turkey
| | - Y Yankol
- Memorial Sisli Hospital, Centre of Organ Transplantation, Istanbul, Turkey
| | - M Kalayoglu
- Memorial Sisli Hospital, Centre of Organ Transplantation, Istanbul, Turkey
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Krespi MR, Tankurt A, Acarlı K, Yankol Y, Kalayoglu M, Kanmaz T. Post-donation evaluation of life of donors of liver transplantation. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1262724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
| | - Asli Tankurt
- Doga College, Counselling Service, Istanbul, Turkey
| | - Koray Acarlı
- Centre of Organ Transplantation, Memorial Sisli Hospital, Istanbul, Turkey
| | - Yucel Yankol
- Centre of Organ Transplantation, Memorial Sisli Hospital, Istanbul, Turkey
| | - Munci Kalayoglu
- Centre of Organ Transplantation, Memorial Sisli Hospital, Istanbul, Turkey
| | - Turan Kanmaz
- Centre of Organ Transplantation, Memorial Sisli Hospital, Istanbul, Turkey
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Change in the donorsʼ quality of life after living-donor liver transplantation surgery. MIDDLE EAST CURRENT PSYCHIATRY 2015. [DOI: 10.1097/01.xme.0000466272.22173.a5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kisu I, Mihara M, Banno K, Umene K, Araki J, Hara H, Suganuma N, Aoki D. Risks for donors in uterus transplantation. Reprod Sci 2013; 20:1406-15. [PMID: 23793471 DOI: 10.1177/1933719113493517] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Uterus transplantation (UTx) is an alternative to gestational surrogacy and adoption for patients with absolute uterine infertility. Studies have been conducted in animals, and UTx is now within the reach of clinical application in humans. Procedures in humans have been published, but many medical, ethical, and social problems and risks of UTx require discussion prior to widespread clinical application, from the perspectives of donors, recipients, families, and newborns. In this article, we summarize the burdens and risks of UTx, with a focus on donors who provide the uterus.
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Affiliation(s)
- Iori Kisu
- 1Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan
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Psychological Factors Influencing Donors' Decision-Making Pattern in Living-Donor Liver Transplantation. Transplantation 2011; 92:936-42. [DOI: 10.1097/tp.0b013e31822e0bb5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Living donor liver transplantation (LDLT) has recently emerged as an effective therapeutic alternative for patients with end-stage liver disease. In the meantime, the health-related quality of life (HRQoL) of the donors is becoming better appreciated. Here we aimed to review the current literature and summarize the effects of liver donation on the long-term HRQoL of living donors. DATA SOURCES A literature search of PubMed using "donors", "living donor liver transplantation", "health-related quality of life", and "donation" was performed, and all the information was collected. RESULTS The varied postoperative outcomes of liver donors are attributive to the different evaluation instruments used. On the whole, donors experienced good long-term physical and mental well-being with a few complaining of compromised quality of life due to mild symptoms or psychiatric problems. The psychosocial dimension has received increasing attention with the vocational, interpersonal and financial impact of liver donation on donors mostly studied. CONCLUSIONS Generally, donors have a good HRQoL after LDLT. Nevertheless, to achieve an ideal donor outcome, further work is necessary to minimize the negative effects as well as to incorporate recent progress in regenerative medicine.
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Søndenaa K, Gondolesi GE, Roayaie S, Goldman JS, Hausken T, Schwartz ME. Functional abdominal complaints occurred frequently in living liver donors after donation. Scand J Gastroenterol 2011; 46:611-5. [PMID: 21114430 DOI: 10.3109/00365521.2010.537685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Donor outcome after living donor liver transplantation has not been examined extensively with regard to postoperative abdominal complaints. We wanted to examine the extent and type of abdominal complaints after removal of a part of the liver and gallbladder in living donors as well as potential similarities with known disorders. METHODS Twelve patients of mixed ethnicity, nine men, aged 18-45 years, and three women, aged 32-46 years, were enrolled in the study during a 3-year period and followed up at 6 and 12 months. Patients filled out questionnaires pertaining to functional abdominal complaints (FAC) using a recognized questionnaire, Rome II, as well as specific abdominal pain symptoms known from gallstone disease. RESULTS FAC occurred in 11 patients at 6 months and nine patients at 12 months while abdominal pain occurred in seven and six patients, respectively. Three patients had FAC but no abdominal pain while two patients had no complaints at 12 months. Irritable bowel syndrome (IBS) was found in the majority of patients. CONCLUSIONS FAC and pain seemed to indicate a general postoperative disorder, of a psychosomatic character, and not connected with removal of part of the liver and gallbladder in particular. However, the occurrence of IBS and FD should merit attention, as they are known to impair quality of life.
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Affiliation(s)
- Karl Søndenaa
- Department of Surgical Sciences, University of Bergen, Norway.
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Noma S, Hayashi A, Uehara M, Uemoto S, Murai T. Comparison between psychosocial long-term outcomes of recipients and donors after adult-to-adult living donor liver transplantation. Clin Transplant 2010; 25:714-20. [PMID: 21044161 DOI: 10.1111/j.1399-0012.2010.01337.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to examine psychosocial states of recipients and donors several years after living donor liver transplantation (LDLT) and to find out the pre-transplant predictors of desirable post-transplant psychosocial states. The recipients and donors of adult-to-adult LDLT at Kyoto University Hospital, Japan, from November 2001 through July 2003 were interviewed and examined by means of questionnaires about anxiety, depression, and quality of life (QOL), and the participants were evaluated by the same test batteries sent by mail three to five yr after LDLT. Twenty-seven pairs of recipients and donors, 13 recipients, and three donors participated in this study. The recipients and the donors had a decline in social QOL. The main predictor of psychosocial states of the recipients was the length of wait for LDLT, and the predictors of the donors were family or support system availability and recipients' depressive states at LDLT. The donors who were spouses of the recipients had better QOL than other donors. It might be better to perform LDLT as soon as possible once LDLT has been judged to be necessary, and the relative who is on close terms with the recipient should be selected as donor.
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Affiliation(s)
- Shun'ichi Noma
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Sakyo, Kyoto, Japan.
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Schroder N, McDonald L, Etringer G, Snyders M. Consideration of psychosocial factors in the evaluation of living donors. Prog Transplant 2008. [DOI: 10.7182/prtr.18.1.w74205541n135284] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Schroder NM, McDonald LA, Etringer G, Snyders M. Consideration of Psychosocial Factors in the Evaluation of Living Donors. Prog Transplant 2008; 18:41-8; quiz 49. [DOI: 10.1177/152692480801800109] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Results of donor outcome studies indicate that most living donors report a positive psychosocial response to donation. However, negative psychosocial outcomes have also been reported. Evaluation guidelines have been proposed, although a standardized evaluation specific to living donors is not yet available. In an effort to determine what psychosocial factors should be considered in a comprehensive evaluation of living donors, an extensive literature review was undertaken that was focused on previously proposed guidelines for the psychosocial evaluation of living donors, research on outcomes among living donors, and other relevant psychosocial data.
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Affiliation(s)
- Nina M. Schroder
- University of Maryland Medical Center, Baltimore (NMS), University of North Carolina Hospitals, Chapel Hill (LAM), University of Utah Hospitals and Clinics, Salt Lake City (GE), Avera McKennan Transplant Institute, Sioux Falls, SD (MS)
| | - Laurie A. McDonald
- University of Maryland Medical Center, Baltimore (NMS), University of North Carolina Hospitals, Chapel Hill (LAM), University of Utah Hospitals and Clinics, Salt Lake City (GE), Avera McKennan Transplant Institute, Sioux Falls, SD (MS)
| | - Geri Etringer
- University of Maryland Medical Center, Baltimore (NMS), University of North Carolina Hospitals, Chapel Hill (LAM), University of Utah Hospitals and Clinics, Salt Lake City (GE), Avera McKennan Transplant Institute, Sioux Falls, SD (MS)
| | - Michele Snyders
- University of Maryland Medical Center, Baltimore (NMS), University of North Carolina Hospitals, Chapel Hill (LAM), University of Utah Hospitals and Clinics, Salt Lake City (GE), Avera McKennan Transplant Institute, Sioux Falls, SD (MS)
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Relevant Factors to Psychological Status of Donors Before Living-Related Liver Transplantation. Transplantation 2007; 84:1255-61. [DOI: 10.1097/01.tp.0000287455.70815.9e] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Trotter JF, Hill-Callahan MM, Gillespie BW, Nielsen CA, Saab S, Shrestha R, Talamantes MM, Weinrieb RM. Severe psychiatric problems in right hepatic lobe donors for living donor liver transplantation. Transplantation 2007; 83:1506-8. [PMID: 17565325 PMCID: PMC3762598 DOI: 10.1097/01.tp.0000263343.21714.3b] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The morbidity and mortality from donation of a right hepatic lobe for living donor liver transplantation (LDLT) is an important issue for this procedure. We report the prevalence of severe psychiatric postoperative complications from the Adult-to-Adult Living Donor Liver Transplantation Cohort study (A2ALL), which was established to define the risks and benefits of LDLT for donors and recipients. METHODS Severe psychiatric complications were evaluated in all donors from the A2ALL study who were evaluated between 1998 and February 2003. RESULTS Of the 392 donors, 16 (4.1%) had one or multiple psychiatric complications, including three severe psychiatric complications (suicide, accidental drug overdose, and suicide attempt). CONCLUSIONS Despite extensive preoperative screening, some donors experience severe psychiatric complications, including suicide, after liver donation. Psychiatric assessment and monitoring of liver donors may help to understand and prevent such tragic events.
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Affiliation(s)
- James F Trotter
- Department of Surgery, University of Colorado, Denver, CO 80262, and Department of Transplant Services, Piedmont Hospital, Atlanta, GA, USA.
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Achille M, Soos J, Fortin MC, Pâquet M, Hébert MJ. Differences in psychosocial profiles between men and women living kidney donors. Clin Transplant 2007; 21:314-20. [PMID: 17488379 DOI: 10.1111/j.1399-0012.2007.00641.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The expansion of kidney transplantation by living donation has led to a disproportional increase in the women to men ratio among donors and this difference cannot be explained on the basis of medical exclusion. The present study was designed to test whether women donors are more likely to (i) display altruistic and gender-typed nurturing behaviour and (ii) be subtly influenced by family pressure to donate and less able to resist this pressure. METHODS All 71 (61% women) individuals who had donated a kidney at our centre between 1995 and 2005 were sent a survey. Thirty-nine individuals (71% response rate; 64% female participation) filled out and returned the survey, which included standardized measures of altruism, self-esteem, family dynamics and endorsement of gender-stereotyped roles, as well as sociodemographic questions and questions about donation. RESULTS Findings show no difference between women and men in terms of the psychological attributes measured. One woman and two men reported having felt pressure to donate, and 92% of women compared with 54% of men reported having felt free to change their mind. Men took longer than women to make the decision to donate. CONCLUSIONS Results suggest that among individuals who have already donated, there is no evidence that women may be more inclined to donate than man because of differences in their psychosocial profiles or because they may be more vulnerable to family pressure. Future research may gain from focusing on men and women donors and non-donors in families where transplantation is being considered.
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Affiliation(s)
- Marie Achille
- Department of Psychology, Université de Montréal, Montreal, QC, Canada.
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16
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Walter M, Dammann G, Papachristou C, Pascher A, Neuhaus P, Danzer G, Klapp BF. Quality of life of living donors before and after living donor liver transplantation. Transplant Proc 2004; 35:2961-3. [PMID: 14697949 DOI: 10.1016/j.transproceed.2003.10.048] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Living donor liver transplantation (LDLT) is becoming an established method for treatment of terminal liver disease in adults. After resection of the right hepatic lobe, postoperative complications can arise in healthy donors, and even individual cases of death have been recorded. There remains, however, little research on the psychosocial aspects in living donors before and after LDLT. Using the WHOQOL questionnaire, this prospective study investigates the quality of life (QoL) in a sample of 28 living donors, including the relationship between postoperative complications and QoL before and 6 months after donation. Before LDLT, the donor QoL is high, above that of the general healthy population. After LDLT, a significant reduction in the QoL appears in the areas of "physical health" and "living conditions." Nevertheless, the QoL remains above the level of the general population. Only two donors showed general QoL values below those of the general population. The postoperative complications had no significant influence on the QoL after transplantation. The high QoL of donors following LDLT indicates a positive psychosocial outcome for the majority of donors, irrespective of donation-related complications. Additional psychosocial studies will be necessary to disclose predictors for an unfavorable psychosocial outcome following LDLT.
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Affiliation(s)
- M Walter
- Psychiatric University Clinic, Willhelm Klein-Strasse 27, CH-4025 Basel, Switzerland.
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Frommer J. [Psychosomatic medicine as a scientific approach for the 21st century]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2004; 50:22-36. [PMID: 14747981 DOI: 10.13109/zptm.2004.50.1.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Subject of the article is the future of psychosomatic medicine as a science in the 21st century. METHODS The state of the art is reviewed from the perspective of philosophy of science and sociology. The subjects of psychosomatic research are dealt with as well as theory and research methodology. RESULTS Psychosomatic medicine will be influenced by a decrease in concrete interpersonal interaction and an increase in interaction directed by electronic media of communication. Holistic theories will be replaced by a variety of consistent and interdisciplinary informed middle range theories. And, last but not least, naive research concepts of the subjects of psychosomatic research will be supplemented by more complex concepts due to the multiplicity of qualitative and quantitative aspects of psychosomatic phenomena. DISCUSSION The theoretical approach developed in this article will be illustrated by concrete examples from some research projects, in particular a project on the psychology of donors in living donor liver transplantation.
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Affiliation(s)
- Jörg Frommer
- Abteilung für Pschosomatische Medizin und Psychotherapie, Klinikum der Otto-von-Guericke-Universität Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany.
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