Ethical Considerations and Post-Operative Outcomes in Good Samaritan Living Liver Donors: What Motivates Individuals to Donate to Strangers
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA
Meeting: 2020 American Transplant Congress
Abstract number: 291
Keywords: Donors, unrelated, Economics, Living-related liver donors, Psychosocial
Session Information
Session Name: Psychosocial and Treatment Adherence
Session Type: Oral Abstract Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:45pm
Presentation Time: 4:27pm-4:39pm
Location: Virtual
*Purpose: Few transplant centers evaluate Good Samaritan living liver donors, secondary to ethical concerns and lack of evidence that the post-operative outcomes are comparable to Related (biologically and emotionally) living liver donors. The aims of this study were to describe the medical, psychosocial, and financial outcomes of the largest cohort of Good Samaritan donors.
*Methods: Good Samaritan living liver donors evaluated between 2010-2019 were included in the study. A medical chart review was performed to assess post-surgical outcomes of the Good Samaritan donors. A subset of Good Samaritan donors were matched to Related living liver donors on age, gender, race, and duration since surgery and interviewed post-operatively. The Good Samaritan and Related donors were compared with regard to medical, psychosocial, and financial outcomes.
*Results: A total of 116 Good Samaritan donors were evaluated between 2010-2019, 59 (51.7%) of whom underwent surgery. The majority of the Good Samaritan donors were female (38, 63.3%) and Caucasian (58, 96.7%). A greater number of females were directed [83.8 versus 16.2%; Chi-square-17.383, p<0.001], while males were more likely to be non-directed donors (69.6% versus 30.4%). Motivations were significantly different [Chi-Square=10.725, p=0.005] with the directed donors reporting a desire to help others (68.4% versus 31.6%) and religion (16.2% versus 0%) as reasons for donating, while non-directed donors reported being motivated by a close relationship with a person with a chronic illness (68.8% versus 31.3%). When compared to Related donors, Good Samaritan donors were not found to be significantly different with regard to surgical complications, psychosocial outcomes or changes in health behaviors, or finances post-donation.
Table 1: Good Samaritan Donors who completed and were declined from surgery
| Characteristics | Surgery Completed (n=59) | Declined from Surgery (n=24) | P-value |
| Age | 35.47 (8.99) | 35.87 (8.31) | 0.852 |
| Male (n, %) | 22 (36.7) | 9 (39.9) | 0.835 |
| Caucasian (n, %) | 58 (96.7) | 21 (91.3) | 0.307 |
| Directed (n, %) | 37 (61.7) | 13 (56.5) | 0.668 |
| Married (n,%) | 33 (55) | 10 (43.5) | 0.604 |
| College degree or higher (n, %) | 31 (51.7) | 11 (47.7) | 0.688 |
| Employed in Helping Field | 27 (45) | 7 (30.4) | 0.227 |
| History of Psychiatric Disorder | 22 (36.7) | 12 (52.2) | 0.199 |
| Directed (n, %)) | 37 (61.7) | 13 (56.5) | 0.668 |
| Employed in Helping Field (n, %) | 27 (45) | 7 (30.4) | 0.227 |
| Surgical Complications | 13 (22) | — | — |
| Clavien-Dindo Classification I | 7 (11.9) | — | — |
| Clavien-Dindo Classification II | 6 (10.2) | — | — |
| Psychiatric Treatment after Donation | 1 (1.7) | — | — |
*Conclusions: This is the largest reported series of Good Samaritan living liver donors. Medical and psychosocial post-operative outcomes were comparable to Related donors. Permitting more Good Samaritan donors to donate may help to reduce the waitlist for liver transplant candidates.
To cite this abstract in AMA style:
Flaig C, Humar A, Kirschner E, Hughes C, Ganesh S, Tevar A, Steel J. Ethical Considerations and Post-Operative Outcomes in Good Samaritan Living Liver Donors: What Motivates Individuals to Donate to Strangers [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/ethical-considerations-and-post-operative-outcomes-in-good-samaritan-living-liver-donors-what-motivates-individuals-to-donate-to-strangers/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress