Is Cholecystectomy Really Harmful? A Long-Term Quality of Life Study in Living Donor Liver Transplantation

Abstract

BackgroundLiving donor liver transplantation (LDLT) is an accepted option for patients with end-stage liver disease. However, it potentially carries the risk of donor morbi-mortality, as well as long-term functional impairment. Cholecystectomy is performed routinely in the donor intervention, but the long-term effect on gastrointestinal (GI)-related quality of life (QoL) has never been explored previously. This study evaluated living donors' overall, abdominal wall-related, activity-level, and GI-related QoL. Materials and MethodsIn total, 21 living liver donors (LLD) (57% women, mean age 45 ± 9 years) were compared to a control group (29 patients) undergoing cholecystectomy for gallbladder polyps (45% women, mean age of 46 ± 7 years). LLD and controls (Ctl) were divided into 2 age groups: LLD-Y and Ctl-Y (25-45 years); and LLD-O and Ctl-O (46-65 years). Generic SF-36, Gastrointestinal Quality of Life Index, EuraHS for abdominal wall status assessment, and International Physical Activity Questionnaire were performed. Standard age-adjusted Portuguese population SF-36 scores were used. ResultsGlobal QoL results were better than Portuguese population scores and not inferior when compared to controls, scoring higher in the LLD-Y group in domains as vitality and mental health (P < .05). The abdominal wall impact was minimal among LLD. The activity level was significantly higher in LLD-Y than in Ctl-Y. Overall GI-related QoL was very close to the maximum score, and GI symptoms were significantly less in LLD-O compared with Ctl-O. ConclusionLDLT had no impact on donors’ general, abdominal wall–related QoL or activity level. The performance of cholecystectomy apparently had no impact on the development of GI-related symptoms.