Skip to main content
CLP 2024 Annual Meeting Main banner
Final Program


CLP 2024 Program
Back

Brief Oral Papers

Subspecialty C-L

Brief Oral Papers Session 13 - Transplant Psychiatry

Assessment of Dangerousness in Living Liver Donors: A Clinical Profile of A2ALL-2 Study Subjects

Friday, November 8, 2024
3:10 PM – 4:25 PM EST
Location: Monroe
Abstract:
Background/Significance: Living liver donors undergo careful psychosocial screening prior to donation with the goal of identifying risk factors for poor outcomes following donation. Perhaps due to the requirement for psychological stability, the rates of post-donation depression are low (Butt 2017). Nevertheless, the literature contains reports of serious psychiatric issues in liver donors including suicide attempts/suicide (Trotter 2007). We use data from the largest prospective study of living liver donors to investigate depressive symptoms and the known post-donation details of these circumstances.

Methods: The adult-to-adult living liver donor (A2ALL-2) consortium of 9 North American transplant centers collected prospective psychosocial data on living liver donors, including pre-donation and at 3-, 6-, and 12-months post-donation. Survey interviews included the PHQ9 and measures of health-related quality of life, relationships with family/partners, and feelings about donation. We obtained IRB approval and a Data Use Agreement to conduct secondary analyses of these data, which had been archived at the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) data repository.

Results/

Discussion: 97% (271/278) of donors who consented and donated participated in psychosocial interviews. Respondents were predominantly female (57%), white (80%), married (63%), and employed full time (61%). Prior to donation donors did not differ on depressive symptoms (assessed with the PHQ9). Following donation, at ≥one time point, 8 participants endorsed the PHQ9 dangerousness item (“thoughts that you would be better off dead or hurting yourself in some way”) ranging from “several days” to “nearly every day”. Across all time points, donors who endorsed the dangerousness item had significantly (p < .001) higher PHQ9 scores (mean PHQ9 scores 8.8 – 10.2 vs 1.7- 2.2), worries about their health, and felt their recovery was slower than expected. They were also significantly more negative about donation, less likely to feel they had helped their recipient in a significant way, felt relationships with family were more difficult, and knowing what they did about donation would not do it again. These donors were also more likely to experience their recipient’s death.

Conclusion/Implications: Slower recovery, health worries, conflicts with family members and death of the recipient may be risk factors for post-donation depression and thoughts of death or self-harm. Assessment of these factors post-donation may be important in improving donor mental health and protecting their safety.