Abstract
BackgroundThe decision to become a living liver donor is a stressful event. Ambivalence in decision making may result in psychological distress. Thus, the purpose of this study was to provide a description of the ambivalence of potential living liver donors, to examine the predictors of ambivalence, and to compare the ambivalence of potential living liver donors with that of actual living liver donors.MethodsThis descriptive and correlational study was conducted in a medical center from August 2013 to December 2015. Self-reported questionnaires were used to collect data. A total of 263 potential living liver donors who were assessed for donation to their parents were included in this study.ResultsThe mean age of the total sample was 30.7 years (SD = 6.39, range = 20–47), and males comprised 53.6% of the sample. The majority of the potential donors had a college education (70.8%) and were single (63.5%). Of the total sample, the mean score for ambivalence was 4.27 (SD = 1.87, range = 0–7). Multivariate analysis revealed that the Mental Component Summary (MCS) of quality of life (β = -0.24, p < 0.01), family support (β = -0.17, p = 0.007), and intimacy (β = -0.13, p = 0.04) were significant protective predictors of ambivalence. Actual living liver donors had significantly lower ambivalence (3.82 versus 4.60), higher intimacy with recipients (3.55 versus 3.34), higher MCS (45.26 versus 42.80), and higher family support (34.39 versus 29.79) than did the remaining potential living liver donors.ConclusionAmbivalence is common in potential living liver donors. The MCS of quality of life, family support, and intimacy were protective predictors in terms of ambivalence. Future research should explore other factors and design interventions targeted toward reducing ambivalence, promoting family support, and enhancing the mental dimensions of quality of life in potential living liver donors.
Highlights
Living donor liver transplantation (LDLT) was developed in the 1980s to overcome the demands of liver transplantation and the shortage of deceased donor organs [1]
Multivariate analysis revealed that the Mental Component Summary (MCS) of quality of life (β = -0.24, p < 0.01), family support (β = -0.17, p = 0.007), and intimacy (β = -0.13, p = 0.04) were significant protective predictors of ambivalence
61.6% of recipients were in stable health, 19.4% had alcohol-related liver cirrhosis, and 42.6% of potential living liver donors (PLDs) donated (Table 1)
Summary
Living donor liver transplantation (LDLT) was developed in the 1980s to overcome the demands of liver transplantation and the shortage of deceased donor organs [1]. Between 1989 and 2001, the estimated rate of LDLT was 37% in Taiwan, 99% in Japan, and 66% in South Korea [3]. According to a more recent report, in 2015, the rate of LDLT was 83% in Taiwan [4]. The outcomes of LDLT are similar to those of deceased liver transplantation [5]. Potential living liver donors should undergo a rigorous assessment and evaluation process to ensure their voluntary donation and to limit or prevent the negative consequence of donation [7,8]. Living liver donors’ physical wellbeing as well as psychological well-being need to be protected throughout the process [9,10,11]. The decision to become a living liver donor is a stressful event. The purpose of this study was to provide a description of the ambivalence of potential living liver donors, to examine the predictors of ambivalence, and to compare the ambivalence of potential living liver donors with that of actual living liver donors.
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