(208) Attitudes towards living-donor liver transplantation among waitlist candidates, support persons, and physicians.

Background

In the United States, there is a persistent disparity between liver transplant candidates and available deceased donors. Despite efforts to meet this need through living-donor liver transplantation (LDLT), living donation comprises only a small proportion of all liver transplants performed each year. There are multiple explanations for low rates of living donation but of particular interest is how the perceptions of organ waitlist patients, their support persons, and health professionals inform the decision to proceed with LDLT.

Methods

This study utilizes questionnaires and structured interviews to examine attitudes toward living-donor liver transplantation among liver transplant waitlist candidates, designated support persons for waitlisted patients, and hepatologists directing patient care. Participants were given subject-specific questionnaires adapted from a previously validated psychosocial questionnaire used in Spain to examine attitudes toward living donation (Rios et al., 2007). Special attention was given to subjects' attitudes toward etiology of transplant indication (e.g. alcoholic cirrhosis). The questionnaire was also followed up by a structured interview performed by study personnel.

Results

Data for this study has yet to be collected. Meaningful data will be collected by the time of poster preparation. 

Discussion

To date, data on patient and physician attitudes towards LDLT has not included granular data such as structured interviews nor delved into differences in attitudes by etiology. Based on previously published research, we expect that both patients on the waiting list and physicians will generally show less support toward related-living donation than cadaveric donation (Martinez et al., 2006; Rios et al., 2007). Additionally, we expect to see generally positive attitudes toward living donation among physicians, as living-donation may be considered an underutilized option in the face of the shortage of liver donations. Attitudes toward etiology of liver failure and need for transplantation represent an interesting and novel area of research in this topic. We expect respondents to be less supportive of living donations needed for etiologies related to alcohol use, as stigma toward alcohol use disorder is pervasive, even among hospital personnel (Soh et al., 2021).

Conclusion

It is critical to explore the attitudes, perceptions, and decision-making factors related to living liver donation among patients, support persons, and physicians in the United States. Their attitudes and perspectives are pivotal in the donation process, from identifying potential donors to providing support and clinical guidance. Our research represents the first such study in the United States to examine attitudes among living donors using structured interviews, with specific focus given to alcohol use. This research may therefore help bridge the gap in knowledge regarding living liver donation among patients and physicians.

References

Ríos A, et al. Attitude of hospital personnel faced with living liver donation in a Spanish center with a living donor liver transplant program. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc. 2007;13(7):1049-1056.

Martínez-Alarcón L, et al. Attitude of kidney patients on the transplant waiting list toward related-living donation. Clin Transplant. 2006;20(6):719-724

Soh KC,et al. Stigma towards alcohol use disorder. Gen Hosp Psychiatry. 2019 May-Jun;58:39-44.
 

Presentation Eligibility: Not previously published or presented.

Diversity, Equity, and Inclusion: Our research examines attitudes toward living donor liver transplantation which special attention given to etiologies related to alcohol use. It's well documented that there are racial and ethnic disparities in liver transplantation for alcohol-associated liver disease in the US and our research may help better characterize the barriers that patients face in accessing transplantation.