Araştırma Makalesi
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Evaluation of Quality of Life in Donors After Living Liver Transplantation

Yıl 2022, Cilt: 17 Sayı: 3, 97 - 106, 02.11.2022
https://doi.org/10.17517/ksutfd.983125

Öz

Abstract
Objective: In this study, it was aimed to examine the effect of transplantation on physical, mental and psychosocial health of donors by evaluating the quality of life of living liver donors after transplantation.
Material and Methods: The study was conducted with three groups at Ege University Faculty of Medicine Organ Transplantation and Research Center. 43 living donors from 2017 and 43 living donors from 2007-2016 who underwent liver transplantation were randomly selected to participate in the study. Also 43 control subjects were selected randomly from the community. The study was conducted by a single interviewer between 01.02.2018 and 31.05.2018 by telephone or e-mail. The socio-demographic data questionnaire, Short Form-36 (SF-36) and Hospital Anxiety-Depression Scale (HADS) prepared by the researchers were applied to all participants.
Results: The mean age of the participants was 38.04±9.84 years, and of these participants 48.1% (n=62) of them were female. When donors and control group were evaluated in terms of their quality of life, no significant difference was found between physical role, energy (vitality) and mental health subgroups.
However, donors have a better quality of life in physical functioning, emotional aspect, social functioning, pain and general health subgroups. It was detected that the quality of life was not affected by age, gender, marital status, educational status, economic status, job loss, comorbidity or disturbance by presence of operational scar. Only sexual problems and the loss of the recipient’s life were observed to have a negative impact on the quality of life. There was no significant difference between the groups in terms of anxiety and depression (p<0.05).
Conclusion: In our study, it was determined that donors’ quality of life was not adversely affected by transplantation procedure. But it was observed that post-transplant follow-ups had not been performed properly. In addition to independent units that monitor physical, mental, and psychosocial health of living donors who undergo major surgery without any medical need, awareness should be increased to follow the quality of life by family medicine discipline which adopts biopsychosocial approach.

Kaynakça

  • Adam R, Karam V, Delvart V, 0’Grady J, Mirza D, Klempnauner J et al. Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol. 2012;57(3):675-688.
  • Morris PJ. Transplantation-a medical miracle of the 20th century. New England Journal of Medicine. 2004;351(26):2678-2680.
  • Starzl TE, Groth CG, Brettschneider L, Penn A, Fulginiti VA, Moon JB et al. Orthotopic homotransplantation of the human liver. Ann Surg.1968;168(3):392-415.
  • Trotter JF. Selection of donors and recipients for living donor liver transplantation. Liver Transplantation. 2000;6(2):52-58.
  • Xu DW, XD Long, Q Xia. A review of life quality in living donors after liver transplantation. International journal of clinical and experimental medicine, 2015;8(1):20.
  • Cheah YL, Simpson MA, Pomposelli JJ, Pomfret EA. Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey. Liver Transpl. 2013;19(5):499-506.
  • Ladner DP, Dew MA, Forney S, Gillespie BW, Brown RS, Merion RM et al. Long-term quality of life after liver donation in the adult to adult living donor liver transplantation cohort study (A2ALL). J Hepatol. 2015;62(2):346-353.
  • Verbesey JE, Simpson MA, Pomposelli JJ, Richman E, Bracken AM, Garrigan K et al. Living donor adult liver transplantation:a longitudinal study of the donor's quality of life. American Journal of Transplantation 2005;5(11):2770-2777.
  • Caruso S, Cianci S, Vitale SG, Fava V, Cutello S, Cianci A. Sexual function and quality of life of women adopting the levonorgestrel-releasing ıntrauterine system (LNG-IUS 13.5 mg) after abortion for unintended pregnancy. Eur. J. Contracept. Reprod. Health Care.2018;23:24–31.
  • Vitale SG, Caruso S, Rapisarda AMC, Cianci S, Cianci A. Isoflavones, calcium, vitamin d and ınulin ımprove quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study. Prz. Menopauzalny. 2018;17:32–38.
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-483.
  • Koçyigit H. Kıisa Form-36 (KF-36)'nin Türkçe versiyonunun güvenilirliği ve geçerliliği. İlac ve Tedavi Dergisi.1999;12:102-106.
  • Aydemir Ö. Hastane anksiyete ve depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi, 1997;8(4): 280-287.
  • International Registry in Organ Donation and Transplantation https://www.irodat.org/img/database/pdf/Newsletter%20June%202020%20updated.pdf (accessed at:18.09.2020)
  • Butt Z, Dew MA, Liu Q, Simpson MA, Smith AR, Zee J et al. Psychological outcomes of living liver donors from a multicenter prospective study: results from the adult-to-adult living donor liver transplantation cohort study2 (A2ALL-2). Am J Transplant. 2017;17(5):1267-1277.
  • Walter M, Bronner E, Pascher A, et al. Psychosocial outcome of living donors after living donor liver transplantation: A pilot study. Clin Transplant. 2002;16(5):339-344.
  • Shen CJ, Huang HL, Chen KH, Steinmüller T, Neuhaus P, Klauoo BF et al. Comparison of liver function, emotional status, and quality of life of living liver donors in Taiwan. Transplantation Proceedings. 2016;48(4):1007-1011.
  • Kroencke S, Nashan B, Fischer L, Erim Y, Schulz KH. Donor quality of life up to two years after living donor liver transplantation: a prospective study. Transplantation. 2014;97(5):582-589.
  • Benzing C, Schmelzle M, Oellinger R, Gruettner K, Muehlisch AK, Raschzok N et al. Living-donor liver transplant: an analysis of postoperative outcome and health-related quality of life in liver donors. Experimental and Clinical Transplantation. 2018;16(5):568-574.
  • Azoulay D, Audureau E, Bhangui P, Belghiti J, Boillot O, Andreani P et al. Living or brain-dead donor liver transplantation for hepatocellular carcinoma: a multicenter, Western, intent-to-treat cohort study. Annals of Surgery. 2017;266(6):1035-1044.
  • Reichman TW, Katchman H, Tanaka T, Greig PD, McGilvray ID, Cattral MS et al. Living donor versus deceased donor liver transplantation: a surgeon-matched comparison of recipient morbidity and outcomes. Transpl Int. 2013;26(8):780-787.
  • Beavers KL, Sandler RS, Fair JH, Johnson MW, Shrestha R. The living donor experience: donor health assessment and outcomes after living donor liver transplantation. Liver Transpl. 2001;7(11):943-947.
  • Trotter JF, Talamantes M, McClure M, Wachs M, Bak T, Trouillot T et al. Right hepatic lobe donation for living donor liver transplantation: impact on donor quality of life. Liver Transpl. 2001;7(6):485-493.
  • Kousoulas L, Emmanouilidis N, Klempnauer J, Lehner F. Living-donor liver transplantation: impact on donor's health-related quality of life. Transplant Proc. 2011;43(10):3584-3587.
  • Lei J, Yan L, Wang W. Donor safety in living donor liver transplantation: a single-center analysis of 300 cases. PLoS One. 2013;8(4):e61769.
  • Kim-Schluger L, Florman SS, Schiano T, O'Rourke M, Gagliardi R, Drooker M et al. Quality of life after lobectomy for adult liver transplantation. Transplantation. 2002;73(10):1593-1597.
  • Song S, Choi DH, Oh TS. The use of locally applied vibration to minimize pain during fractional co2 laser therapy in living liver-donor scar management. Arch Plast Surg. 2016;43(6):570-574.
  • Ghobrial RM, Freise CE, Trotter JF, Tong l, Ojo AO, Fair JH, et al. Donor morbidity after living donation for liver transplantation. Gastroenterology. 2008;135(2):468-476.
  • Shamsaeefar A, Nikeghbalian S, Kazemi K, Gholami S, Sayadi M, Azadian F et al. Donors' quality of life after living donor liver transplantation: Shiraz organ transplant center experience. Int J Organ Transplant Med. 2020;11(2):82-87.
  • Raza MH, Kim MH, Ding L, Fong TL, Romero c, Genyk Y et al. Long-term financial, psychosocial, and overall health-related quality of life after living liver donation. J Surg Res. 2020;253:41-52.
  • Erim Y, Beckmann M, Kroencke S, Valentin-Gamazo C, Malago M, Broering D et al. Psychological strain in urgent indications for living donor liver transplantation. Liver Transpl. 2007;13(6):886-895.
  • Shi Y, Liu C, Zhang H, Huang Y, Sun M, Wang W et al. Changes in the quality of life of living liver donors: A meta-analysis [published online ahead of print, 2020 May 6]. Int J Nurs Stud. 2020;109:103586.

Canlı Karaciğer Donörlerinde Yaşam Kalitesinin Değerlendirilmesi

Yıl 2022, Cilt: 17 Sayı: 3, 97 - 106, 02.11.2022
https://doi.org/10.17517/ksutfd.983125

Öz

Özet
Amaç: Bu çalışmada, canlı karaciğer donörlerinin transplantasyon sonrası yaşam kalitelerinin değerlendirilerek, transplantasyonun donörlerin fiziksel, ruhsal ve psikososyal sağlıklarına etkisinin incelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Ege Üniversitesi Tıp Fakültesi Organ Nakli ve Araştırma Merkezi’nde 3 grupta çalışma yürütüldü. 2017 yılında opere olan 43 canlı karaciğer donörü ve 2007-2016 yılları arasındaki 43 canlı donörü çalışmaya katılmak üzere rastgele seçildi. Ayrıca topluluktan rastgele 43 kontrol örneği seçildi.
Çalışma 01.02.2018-31.05.2018 tarihleri arasında tek görüşmeci tarafından telefon veya e-posta yoluyla gerçekleştirildi. Tüm katılımcılara araştırmacılar tarafından hazırlanan sosyodemografik veri anketi, Kısa Form-36 (KF-36) ve Hastane Anksiyete-Depresyon Ölçeği (HADS) uygulandı.
Bulgular: Katılımcıların yaş ortalaması 38.04±9.84 yıl olup, bu katılımcıların %48.1’i (n=62) kadındı. Donör ve kontrol grubu yaşam kaliteleri açısından değerlendirildiğinde fiziksel rol, enerji (canlılık) ve ruh sağlığı alt grupları arasında anlamlı fark bulunmadı. Ancak donörlerin fiziksel işlevsellik, emosyonel yön, sosyal işlevsellik, ağrı ve genel sağlık alt gruplarında daha iyi bir yaşam kalitesi vardı. Yaşam kalitesinin yaş, cinsiyet, medeni durum, eğitim durumu, ekonomik durum, iş kaybı, komorbidite veya ameliyat skarının varlığından etkilenmediği belirlendi. Sadece cinsel sorunlar ve donörün hayatını kaybetmesinin
yaşam kalitesini olumsuz etkilediği gözlemlendi. Anksiyete ve depresyon açısından gruplar arasında anlamlı fark yoktu (p<0.05)
Sonuç: Çalışmamızda donörlerin yaşam kalitesinin transplantasyondan olumsuz etkilenmediği belirlendi. Ancak nakil sonrası takiplerin gerektiği gibi yapılmadığı görüldü. Herhangi bir tıbbi gereksinim duymadan majör cerrahi geçiren canlı donörlerin fiziksel, ruhsal ve psikososyal sağlıklarını izleyen bağımsız birimlerin yanı sıra biyopsikososyal yaklaşımı benimseyen aile hekimliği disiplini ile yaşam kalitesinin takibi konusunda farkındalık artırılmalıdır.

Kaynakça

  • Adam R, Karam V, Delvart V, 0’Grady J, Mirza D, Klempnauner J et al. Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol. 2012;57(3):675-688.
  • Morris PJ. Transplantation-a medical miracle of the 20th century. New England Journal of Medicine. 2004;351(26):2678-2680.
  • Starzl TE, Groth CG, Brettschneider L, Penn A, Fulginiti VA, Moon JB et al. Orthotopic homotransplantation of the human liver. Ann Surg.1968;168(3):392-415.
  • Trotter JF. Selection of donors and recipients for living donor liver transplantation. Liver Transplantation. 2000;6(2):52-58.
  • Xu DW, XD Long, Q Xia. A review of life quality in living donors after liver transplantation. International journal of clinical and experimental medicine, 2015;8(1):20.
  • Cheah YL, Simpson MA, Pomposelli JJ, Pomfret EA. Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey. Liver Transpl. 2013;19(5):499-506.
  • Ladner DP, Dew MA, Forney S, Gillespie BW, Brown RS, Merion RM et al. Long-term quality of life after liver donation in the adult to adult living donor liver transplantation cohort study (A2ALL). J Hepatol. 2015;62(2):346-353.
  • Verbesey JE, Simpson MA, Pomposelli JJ, Richman E, Bracken AM, Garrigan K et al. Living donor adult liver transplantation:a longitudinal study of the donor's quality of life. American Journal of Transplantation 2005;5(11):2770-2777.
  • Caruso S, Cianci S, Vitale SG, Fava V, Cutello S, Cianci A. Sexual function and quality of life of women adopting the levonorgestrel-releasing ıntrauterine system (LNG-IUS 13.5 mg) after abortion for unintended pregnancy. Eur. J. Contracept. Reprod. Health Care.2018;23:24–31.
  • Vitale SG, Caruso S, Rapisarda AMC, Cianci S, Cianci A. Isoflavones, calcium, vitamin d and ınulin ımprove quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study. Prz. Menopauzalny. 2018;17:32–38.
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-483.
  • Koçyigit H. Kıisa Form-36 (KF-36)'nin Türkçe versiyonunun güvenilirliği ve geçerliliği. İlac ve Tedavi Dergisi.1999;12:102-106.
  • Aydemir Ö. Hastane anksiyete ve depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi, 1997;8(4): 280-287.
  • International Registry in Organ Donation and Transplantation https://www.irodat.org/img/database/pdf/Newsletter%20June%202020%20updated.pdf (accessed at:18.09.2020)
  • Butt Z, Dew MA, Liu Q, Simpson MA, Smith AR, Zee J et al. Psychological outcomes of living liver donors from a multicenter prospective study: results from the adult-to-adult living donor liver transplantation cohort study2 (A2ALL-2). Am J Transplant. 2017;17(5):1267-1277.
  • Walter M, Bronner E, Pascher A, et al. Psychosocial outcome of living donors after living donor liver transplantation: A pilot study. Clin Transplant. 2002;16(5):339-344.
  • Shen CJ, Huang HL, Chen KH, Steinmüller T, Neuhaus P, Klauoo BF et al. Comparison of liver function, emotional status, and quality of life of living liver donors in Taiwan. Transplantation Proceedings. 2016;48(4):1007-1011.
  • Kroencke S, Nashan B, Fischer L, Erim Y, Schulz KH. Donor quality of life up to two years after living donor liver transplantation: a prospective study. Transplantation. 2014;97(5):582-589.
  • Benzing C, Schmelzle M, Oellinger R, Gruettner K, Muehlisch AK, Raschzok N et al. Living-donor liver transplant: an analysis of postoperative outcome and health-related quality of life in liver donors. Experimental and Clinical Transplantation. 2018;16(5):568-574.
  • Azoulay D, Audureau E, Bhangui P, Belghiti J, Boillot O, Andreani P et al. Living or brain-dead donor liver transplantation for hepatocellular carcinoma: a multicenter, Western, intent-to-treat cohort study. Annals of Surgery. 2017;266(6):1035-1044.
  • Reichman TW, Katchman H, Tanaka T, Greig PD, McGilvray ID, Cattral MS et al. Living donor versus deceased donor liver transplantation: a surgeon-matched comparison of recipient morbidity and outcomes. Transpl Int. 2013;26(8):780-787.
  • Beavers KL, Sandler RS, Fair JH, Johnson MW, Shrestha R. The living donor experience: donor health assessment and outcomes after living donor liver transplantation. Liver Transpl. 2001;7(11):943-947.
  • Trotter JF, Talamantes M, McClure M, Wachs M, Bak T, Trouillot T et al. Right hepatic lobe donation for living donor liver transplantation: impact on donor quality of life. Liver Transpl. 2001;7(6):485-493.
  • Kousoulas L, Emmanouilidis N, Klempnauer J, Lehner F. Living-donor liver transplantation: impact on donor's health-related quality of life. Transplant Proc. 2011;43(10):3584-3587.
  • Lei J, Yan L, Wang W. Donor safety in living donor liver transplantation: a single-center analysis of 300 cases. PLoS One. 2013;8(4):e61769.
  • Kim-Schluger L, Florman SS, Schiano T, O'Rourke M, Gagliardi R, Drooker M et al. Quality of life after lobectomy for adult liver transplantation. Transplantation. 2002;73(10):1593-1597.
  • Song S, Choi DH, Oh TS. The use of locally applied vibration to minimize pain during fractional co2 laser therapy in living liver-donor scar management. Arch Plast Surg. 2016;43(6):570-574.
  • Ghobrial RM, Freise CE, Trotter JF, Tong l, Ojo AO, Fair JH, et al. Donor morbidity after living donation for liver transplantation. Gastroenterology. 2008;135(2):468-476.
  • Shamsaeefar A, Nikeghbalian S, Kazemi K, Gholami S, Sayadi M, Azadian F et al. Donors' quality of life after living donor liver transplantation: Shiraz organ transplant center experience. Int J Organ Transplant Med. 2020;11(2):82-87.
  • Raza MH, Kim MH, Ding L, Fong TL, Romero c, Genyk Y et al. Long-term financial, psychosocial, and overall health-related quality of life after living liver donation. J Surg Res. 2020;253:41-52.
  • Erim Y, Beckmann M, Kroencke S, Valentin-Gamazo C, Malago M, Broering D et al. Psychological strain in urgent indications for living donor liver transplantation. Liver Transpl. 2007;13(6):886-895.
  • Shi Y, Liu C, Zhang H, Huang Y, Sun M, Wang W et al. Changes in the quality of life of living liver donors: A meta-analysis [published online ahead of print, 2020 May 6]. Int J Nurs Stud. 2020;109:103586.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Gizem Bayam 0000-0003-1239-9146

Gülseren Pamuk 0000-0001-5556-9630

Hilal Aksoy 0000-0002-3330-9317

Murat Zeytunlu Bu kişi benim 0000-0001-6911-8953

Kurtuluş Öngel 0000-0002-8846-2810

Erken Görünüm Tarihi 1 Kasım 2022
Yayımlanma Tarihi 2 Kasım 2022
Gönderilme Tarihi 15 Ağustos 2021
Kabul Tarihi 11 Kasım 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 17 Sayı: 3

Kaynak Göster

AMA Bayam G, Pamuk G, Aksoy H, Zeytunlu M, Öngel K. Evaluation of Quality of Life in Donors After Living Liver Transplantation. KSÜ Tıp Fak Der. Kasım 2022;17(3):97-106. doi:10.17517/ksutfd.983125