Background:Little is known about living liver donation's impact on donor personal relationships and financial outcomes. We examined these areas in a prospective 9-center liver donor study.

Methods: Using validated measures, donors were surveyed pre-donation and 3, 6, 12 and 24 mos post-donation. Repeated measures regression models were used to examine outcomes over time and identify demographic, clinical and pre-donation relationship/financial predictors.

Results:Out of 271 donors, 43%, 48% and 55% had improved spousal, family and recipient relationships following donation, respectively. Encouragement to donate (OR=2.25, 95% CI 1.24-4.07) predicted improved family relationship and older donor age (OR=1.34 per 10 yrs, CI 1.09-1.65) predicted improved recipient relationship. Familial esteem and gratitude were highest at 3 mos but diminished over time. Donors whose recipient died reported less esteem (OR=0.45, CI 0.21-0.92) and gratitude (1.52 lower on scale of 1-10, CI 0.74-2.31) from their families. In addition, family history of disapproval predicted less family gratitude, while longer donation hospital stay and positive pre-donation recipient relationship predicted higher gratitude. From 3 mos to 2 yrs post-donation, the percent that reported experiencing out-of-pocket donation medical expenses, that expenses were a burden, and costs were more than expected fell from 26% to 9%, 40% to 19% and 16% to 12%, respectively. Of those employed pre-donation, 34% at 3 mos reported changing or modifying work due to donation compared to 1% at 2 yrs. Longer hospital stay, anticipating being off work >3 mos, concerns over donation costs or missing work, technical/clerical or lower work positions, and lower household income predicted one or more adverse financial outcomes.

Conclusions: Relationship changes following living liver donation are overall positive but we identified key areas for donor education and post-donation monitoring to reduce financial disincentives of donation.

CITATION INFORMATION: DiMartini A, Dew M, Liu Q, Simpson M, Ladner D, Smith A, Zee J, Abbey S, Gillespie B, Weinrieb R, Mandell S, Fisher R, Emond J, Freise C, Butt Z. Personal Relationships and Financial Outcomes in Living Liver Donors. Am J Transplant. 2016;16 (suppl 3).

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