Development of a screening instrument assessing psychosocial eligibility of living liver donors and a questionnaire of donors' specific health-relatedquality of life
Final Report Abstract
A crucial objective of the psychosocial evaluation of living organ donors is to limit psychiatric risks after donation. In this project we have shown that a good quality of life and psychosocial outcome can be achieved for pediatric and adult LDLT donors, when a careful psychosomatic selection has been carried out. Protective and risk factors influencing mental health were analysed. Factors of resilience like sense of coherence and social support predicted living liver donors’ emotional stress, particularly depression. Actual donors showed a better mental QOL and higher self-esteem postoperatively than potential donors.III Donors for recipients with acute liver failure or liver cancer had reduced quality of life and increased anxiety compared to donors with less urgent chronic liver disease. However, these parameters improved following transplantation, so donors’ mental burden is of temporary nature. Our findings have shown that the principle of protection of the donors from emotional harm is ensured in the LDLT setting. To optimize the process of donor selection and counseling as well as the outcome assessment of donors’ quality of life, we developed two evidence-based, economical psychometric instruments: A screening questionnaire assessing psychological eligibility of living liver donors and a questionnaire of donors’ specific healthrelated quality of life. Because of the decreased number of living liver donations in Germany we expanded our studies to living kidney donation and initiated cooperations. On the basis of our previous research, discriminating variables were selected for the questionnaires; items and scales were constructed following psychometric principles. Since postoperative data are needed, the psychometric testing of the specific quality of life instrument is still in progress. The reliability and validity testing of the eligibility screening questionnaire yielded 5 factors: „Regulation of distance and closeness”, ”Emotional neediness”, “Social contacts”, “Excessive absorption“, and „Pain and health perception“ explaining a variance of app. 50%. In conclusion, the Donor Eligibility Assessment Questionnaire (DEAQ) is a reliable and valid instrument for the assessment of the psychosocial eligibility of living donors. Cut-off-values for eligibility of donors are being developed. In this way, an economic, evidence-based evaluation of living donors will be assured and the procedure of living liver donation will be optimized.
Publications
- Selection of donors for adult living-donor liver donation: Results of the assessment of the first 205 donor candidates. Psychosomatics 2008, 49: 143-151
Erim Y, Beckmann M, Valentin-Gamazo C, Malago M, Frilling A, Schlaak J, Gerken G, Broelsch CE, Senf W
(See online at https://doi.org/10.1176/appi.psy.49.2.143) - Sense of coherence and social support predict living liver donors' emotional stress prior to living-donor liver transplantation. Clin Transplant 2008, 22: 273-280
Erim Y, Beckmann M, Kroencke S, Schulz KH, Tagay S, Valentin-Gamazo C, Malago M, Frilling A, Broelsch CE, Senf W
(See online at https://doi.org/10.1111/j.1399-0012.2007.00782.x) - Single-center experience on liver transplantation for hepatocellular carcinoma arising in alcoholic cirrhosis: Results and ethical issues. Eur Surg Res 2008, 40: 7-13
Sotiropoulos GC, Beckebaum S, Lang H, Frilling A, Molmenti EP, Cicinnati VR, Saner FH, Erim Y, Baba HA, Malagó M, Broelsch CE
(See online at https://doi.org/10.1159/000107615) - The factorial structure of the Chronic Liver Disease Questionnaire (CLDQ). Qual Life Res 2008, 17: 575-584
Schulz KH, Kroencke S, Ewers H, Schulz H, Younossi ZM
(See online at https://doi.org/10.1007/s11136-008-9332-7) - Mental and physical quality of life in actual living liver donors versus potential living liver donors: A prospective, controlled, multicenter study. Liver Transpl 2009, 15: 1676-1687
Schulz KH, Kroencke S, Beckmann M, Nadalin S, Paul A, Fischer L, Nashan B, Senf W, Erim Y
(See online at https://doi.org/10.1002/lt.21917) - Depression and protective factors of mental health in people with hepatitis C: A questionnaire survey. Int J Nurs Stud 2010, 47: 342-349
Erim Y, Tagay S, Beckmann M, Bein S, Cicinnati V, Beckebaum S, Senf W, Schlaak JF
(See online at https://doi.org/10.1016/j.ijnurstu.2009.08.002) - Psychosomatische Aspekte der Leberlebendspende. Chirurg 2010, 81: 820-825
Erim Y, Beckmann M, Gerken G, Paul A, Senf W, Beckebaum S
(See online at https://doi.org/10.1007/s00104-009-1876-8)
