Background: Living liver donors (LLD) are healthy adults donating a portion of their liver to a recipient in need. To justify the risk to LLD, we must understand the potential impact of the surgery. Our purpose was to evaluate psychological outcomes in LLD.

Methods: We collected prospective data (pre-donation, 3, 6, 12 and 24 mos post-donation) from 271 LLD at 9 centers in the Adult to Adult Living Donor Liver Transplantation Cohort Study (A2ALL), using validated measures, such as the SF-36 and the Primary Care Evaluation of Mental Disorders (PRIME-MD). Repeated measures linear regression models identified demographic, clinical, or pre-donation psychosocial predictors of Post Traumatic Growth Inventory (PTGI) and the Better Person Scale. Outcomes endorsed by less than 10% of donors were not modeled.

Results: On the PRIME-MD, 2-5% of LLD screened positive for alcohol abuse, 2-3% for non-panic general anxiety and 0-3% for major depressive syndrome from pre-donation to 2 yrs post. These LLD typically only had significant symptoms at one time point and were rarely comorbid with another PRIME-MD condition. On average, LLD scored nearly a standard deviation better (8-9.5 points) on the mental component summary of the SF-36 than the US general population, but 5-10% were impaired (> 0.5 SD below US population mean). Time since donation, relationship to recipient, donor sex, recipient death, and several psychological factors significantly predicted donor perceptions of being a better person. PTGI was stable from 1 to 2 yrs post-donation, with older LLD and those discouraged from donating experiencing less growth. LLD who anticipated their life would be more worthwhile after donation had more growth. All of the above tests have p-values <0.05.

Conclusion: LLD report low incidence of alcohol abuse, anxiety, and depressive disorders in their first two years. On average, LLD report high mental HRQOL, although a subset of LLD may benefit from more active surveillance.

CITATION INFORMATION: Butt Z, Dew M, Liu Q, Simpson M, Smith A, Zee J, Gillespie B, Abbey S, Ladner D, Weinreib R, Fisher R, Hafliger S, Terrault N, Burton J, DiMartini A. Longitudinal Psychological Outcomes of Living Liver Donors. Am J Transplant. 2016;16 (suppl 3).

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