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

Transplant Proc. 2020 Apr;52(3):873-880. doi: 10.1016/j.transproceed.2020.01.038. Epub 2020 Mar 2.

Abstract

Background: Living 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 methods: In 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.

Results: Global 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.

Conclusion: LDLT 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.

Publication types

  • Evaluation Study

MeSH terms

  • Abdominal Wall
  • Adult
  • Cholecystectomy / adverse effects*
  • Cholecystectomy / methods
  • Cholecystectomy / psychology
  • Female
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / psychology*
  • Humans
  • Liver Transplantation
  • Living Donors / psychology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / psychology*
  • Quality of Life / psychology*
  • Tissue and Organ Harvesting / adverse effects*
  • Tissue and Organ Harvesting / methods
  • Tissue and Organ Harvesting / psychology
  • Treatment Outcome