Psychosocial evaluation of living liver donors-State of current practices in the United States.
Recommended Citation
Zimbrean PC, Rubman S, Andacoglu O, Bakhai D, Clifton E, Deng Y, Doshi M, Emamaullee J, Gan G, Holmes R, Jaber L, Jackson W, Joyce M, Kalil R, Kumar V, Laflen J, Lentine K, Prashar R, Winder GS, Yadav A, and Liapakis A. Psychosocial evaluation of living liver Donors- State of current practices in the US. Liver Transpl 2023.
Document Type
Article
Publication Date
10-23-2023
Publication Title
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Abstract
We surveyed living donor liver transplant programs in the United States to describe practices in the psychosocial evaluation of living donors focused on (1) composition of psychosocial team; (2) domains, workflow, and tools of the psychosocial assessment; (3) absolute and relative mental health-related contraindications to donation; and (4) postdonation psychosocial follow-up. We received 52 unique responses, representing 33 of 50 (66%) of active living donor liver transplant programs. Thirty-one (93.9%) provider teams included social workers, 22 (66.7%) psychiatrists, and 14 (42.4%) psychologists. Validated tools were rarely used, but domains assessed were consistent. Respondents rated active alcohol (93.8%), cocaine (96.8%), and opioid (96.8%) use disorder, as absolute contraindications to donation. Active suicidality (97%), self-injurious behavior (90.9%), eating disorders (87.9%), psychosis (84.8%), nonadherence (71.9%), and inability to cooperate with the evaluation team (78.1%) were absolute contraindications to donation. There were no statistically significant differences in absolute psychosocial contraindications to liver donation between geographical areas or between large and small programs. Programs conduct postdonation psychosocial follow-up (57.6%) or screening (39.4%), but routine follow-up of declined donors is rarely conducted (15.8%). Psychosocial evaluation of donor candidates is a multidisciplinary process. The structure of the psychosocial evaluation of donors is not uniform among programs though the domains assessed are consistent. Psychosocial contraindications to living liver donation vary among the transplant programs. Mental health follow-up of donor candidates is not standardized.
PubMed ID
37861339
ePublication
ePub ahead of print
