Liver donors may suffer long-term effects after donation

People who donate a piece of their liver may experience long-term physical, psychological and financial adverse effects as a result, a new study suggests.

Researchers surveyed 517 adults who had donated a piece of their liver three to 10 years earlier at nine transplant centers in the U.S. and Canada. “We were surprised donors continued to report some issues,” study leader Mary Amanda Dew told Reuters Health by phone. “We thought by the time they were so far out from the date they donated part of their livers, they might not have difficulties.”

Previous reports had tracked donors for only a year or two after donation. Their longer-term health and quality of life hasn’t been well studied, she said. Organ donors are highly screened and are generally healthy psychologically and physically, she noted. In this study, however, even many years after donation, many were reporting problems that were clearly linked to their original surgery, she said.

Seventy-eight donors, or 15 percent, reported donation-related medical problems – most often hernias, digestive issues, chronic diarrhea, and problems with scar tissue. Also, 111 donors said they could not do some physical activities as well as they could before donation. In particular, the limitations involved exercises or activities requiring abdominal strength, vigorous physical activity, and lifting significant weight.

Finally, up to about a third of the donors reported health worries due to donation, with concern about future health being most frequently endorsed. Still, more than 90 percent of donors said they would make the same decision to donate again, and most had positive overall feelings about donating.

The good news, according to Dew, is that donors’ general quality of life was as good as or better than for others in their peer group. Even if the transplant recipient didn’t survive, donors felt positively about the donation, she said.

There’s a psychological benefit to knowing you did everything you could to save someone’s life, Dew said. “Another important issue concerns financial burdens donors may have due to the donation,” Dew said. “We are aware that this financial burden exists. We need organs but it’s unfair for donors to have to take on this financial burden.”

Based on their responses, the researchers were able to divide participants into five distinct “clusters.” The largest consisted of 158 donors with a high degree of physical concerns and some socioeconomic concerns, along with some psychological benefit.

The next two largest clusters each contained 109 donors. In one of these groups, donors reported high psychological benefit but some degree of physical and socioeconomic concerns. In the other, donors didn’t get much psychological benefit from donating but they also didn’t have much in the way of physical and socioeconomic concerns.

The fourth largest group, with 74 donors, had the best outcomes, with the highest psychological benefit and mostly low physical and socioeconomic concerns.

And finally, the smallest group consisted of 57 donors with the lowest psychological benefit plus some physical and socioeconomic concerns.

Dr. Rohit Loomba, a member of the American Liver Foundation’s National Medical Advisory Committee, told Reuters Health by email that physical and financial effects “several years down the road” after liver donation is a new finding.

Loomba, who wasn’t involved in the study, told Reuters Health by email, “Finding five different groups helps us peek into how we can move donors from one pool to another to minimize physical and financial burden in future.”