Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2022; 14(10): 1899-1906
Published online Oct 27, 2022. doi: 10.4254/wjh.v14.i10.1899
Quality of life, depression and anxiety in potential living liver donors for pediatric recipients: A retrospective single center experience
Paula K Reine, Flavia Feier, Eduardo Antunes da Fonseca, Rosely G Hernandes, Joao Seda-Neto
Paula K Reine, Rosely G Hernandes, Department of Psychology, Hospital Sírio-Libanês, São Paulo 01308901, Brazil
Flavia Feier, Department ofLiver Transplantation, Santa Casa de Porto Alegre, Porto Alegre 90020090, Brazil
Eduardo Antunes da Fonseca, Joao Seda-Neto, Department of Liver Transplantation, Hospital Sírio-Libanês, São Paulo 01308901, Brazil
Author contributions: Reine PK contributed to study design, data collection, manuscript writing; Feier F contributed to data analysis, manuscript writing; Hernandes RG contributed to data collection, manuscript final version critical analysis; da Fonseca EA contributed to manuscript writing, manuscript final version critical analysis; Seda-Neto J contributed to study design, manuscript writing, data analysis.
Institutional review board statement: The study was reviewed and approved for publication by our Institutional Reviewer.
Informed consent statement: It was exempted because of the retrospective nature of the study by the Hospital’s Ethics Committee.
Conflict-of-interest statement: None of the authors have any conflicts of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available upon request from the corresponding author at joaoseda@gmail.com.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joao Seda-Neto, PhD, Surgeon, Department of Liver Transplantation, Hospital Sírio-Libanês, Rua Adma Jafet, 91, São Paulo 01308901, Brazil. joaoseda@gmail.com
Received: June 6, 2022
Peer-review started: June 6, 2022
First decision: July 12, 2022
Revised: August 21, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: October 27, 2022
Abstract
BACKGROUND

Living donor liver transplantation is a safe alternative for patients on a liver transplant list. Donor evaluation goes beyond physical variables to include social, emotional, and ethical aspects. The role of pre-donation sociopsychological evaluation of the donor candidate is as important to the success of the procedure as is the medical assessment. Success implies recovery from the operation and prompt engagement in pre-transplant professional and social activities, without leading to psychological or physical distress. Psychological profiling of potential living liver donors (PLLD) and evaluation of quality of life (QOL) can influence outcomes.

AIM

To evaluate the socio-demographics and psychological aspects (QOL, depression, and anxiety) of PLLD for pediatric liver transplantation in a cohort of 250 patients.

METHODS

This was a retrospective cohort study of 250 PLLD who underwent psychological pre-donation evaluation between 2015 and 2019. All the recipients were children. The Beck anxiety inventory, Beck depression inventory, and 36-item short-form health survey (SF-36) scores were used to evaluate anxiety (Beck anxiety inventory), depression (Beck depression inventory), and QOL, respectively.

RESULTS

A total of 250 PLLD were evaluated. Most of them were women (54.4%), and the mean age was 29.2 ± 7.2 years. A total of 120 (48.8%) PLLD were employed at the time of evaluation for donation; however, most had low income (57% earned < 2 times the minimum wage). A total of 110 patients (44%) did not finish the donation process, and 247 PLLD answered a questionnaire to evaluate depression, anxiety, and QOL (SF-36). Prevalence of depression was of 5.2% and anxiety 3.6%. Although most of the PLLD were optimistic regarding the donation process and never had doubts about becoming a donor, some traces of ambivalence were observed: 46% of the respondents said they would feel relieved if a deceased donor became available.

CONCLUSION

PLLD had a low prevalence of anxiety and depression. The foundation for effective and satisfactory results can be found in the pre-transplantation process, during which evaluations must follow rigorous criteria to mitigate potential harm in the future. Pre-donation psychological evaluation plays a predictive role in post-donation emotional responses and mental health issues. The impact of such findings on the donation process and outcomes needs to be further investigated.

Keywords: Liver transplantation, Children, Outcomes, Living donation

Core Tip: The role of a pre-donation sociopsychological evaluation of a donor candidate is as important to the success of the procedure as is the medical assessment. This implies recovery from the operation and prompt engagement in pre-transplant professional and social activities without leading to psychological or physical distress. The present study evaluates socio-demographics and psychological aspects of potential living liver donors for pediatric liver transplantation in a cohort of 250 patients. It also investigates specific questions regarding donation, decision-making processes, and feelings of ambivalence.