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01 November 2005

Psychosocial situation of living donors: moods, complaints, and self-imagebefore and after liver transplantation.

Marc Walter, Gerhard Dammann, Joachim Küchenhoff, Jörg Frommer, Frank Schoeneich, Gerhard Danzer, Burghard F Klapp

Med Sci Monit 2005; 11(11): CR503-509 :: ID: 430360

Abstract

Background: Living donor liver transplantation (LDLT) has developed intoan established therapy for terminal liver diseases. There is, however, little knowledge of the psychosocialsituation of living donors. The aim of this study was to investigate the course of donors' moods, physicalcomplaints, and self-image in the preoperative decision process and six months after surgery. Material/Methods:Fifty-two potential donors were evaluated at the Charité Berlin. On the basis of the clinical interview,seven (13%) potential donors were not recommended for LDLT for psychosocial reasons. Twenty-six donorsunderwent liver resection and were re-evaluated six months after surgery. Donors' moods were investigatedwith the Berlin Mood Questionnaire (BMQ) and their physical complaints were assessed by the Giessen ComplaintQuestionnaire (GCQ). The Narcissism Inventory (NI-90) was used to assess their self-image. Results: Potentialdonors who were not recommended for surgery showed significantly higher values for negative moods, physicalcomplaints, and "narcissistic rage". After surgery, donors' self-images were generally stabilized. Nevertheless,five donors (19%) showed high values for "threatened self" before and after transplantation, as wellas high values for negative moods and complaints after LDLT. Conclusions: The resection of the righthepatic lobe holds promise of a good psychosocial outcome, with stable self-image and self-esteem formost donors. A minority of donors exhibited enhanced perception of distress and low self-esteem beforeand after surgery, which can easily be overlooked in the preoperative evaluation. A psychometric assessmentof self-image before transplantation should be added to the clinical interview evaluation of potentialliving donors.

Keywords: Affect, Emotions, Liver Transplantation - psychology, Living Donors - psychology, Self Concept

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750