Predictors of donor follow-up after living donor liver transplantation

Liver Transpl. 2014 Aug;20(8):967-76. doi: 10.1002/lt.23912.

Abstract

Donor safety in living liver donation is of paramount importance; however, information on long-term outcomes is limited by incomplete follow-up. We sought to ascertain factors that predicted postdonation follow-up in 456 living liver donors in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study. Completed donor follow-up was defined as physical, phone, or laboratory contact at a given time point. Univariate and multivariate mixed effects logistic regression models, using donor and recipient demographic and clinical data and donor quality-of-life data, were developed to predict completed follow-up. Ninety percent of the donors completed their follow-up in the first 3 months, and 83% completed their follow-up at year 1; rates of completed follow-up ranged from 57% to 72% in years 2 to 7 and from 41% to 56% in years 8 to 10. The probability of completed follow-up in the first year was higher for white donors [odds ratio (OR) = 3.27, 95% confidence interval (CI) = 1.25-8.58] but lower for donors whose recipients had hepatitis C virus or hepatocellular carcinoma (OR = 0.34, 95% CI = 0.17-0.69). After the first year, an older age at donation predicted more complete follow-up. There were significant center differences at all time points (OR range = 0.29-10.11), with center variability in both returns for in-center visits and the use of phone/long-distance visits. Donor follow-up in the first year after donation was excellent but decreased with time. Predictors of follow-up varied with the time since donation. In conclusion, adapting best center practices (enhanced through the use of telephones and social media) to maintain contact with donors represents a significant opportunity to gain valuable information about long-term donor outcomes.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / surgery
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hepatitis C / complications
  • Hepatitis C / surgery
  • Humans
  • Liver Failure / surgery*
  • Liver Neoplasms / complications
  • Liver Neoplasms / surgery
  • Liver Transplantation / methods*
  • Living Donors*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Probability
  • Tissue and Organ Procurement
  • Treatment Outcome
  • Young Adult