Changes in the quality of life of living liver donors: A meta-analysis

Background: Comprehending the physical, psychological, social benefits, and harm associated with liver donation is critical in promoting practices to maintain donors' long-term health. However, changes in quality of life among living liver donors pre- and post-donation have not been established. Objective: This meta-analysis of prospective longitudinal studies examined the quality of life changes among living liver donors pre- and post-donation. Methods: PubMed, Embase, CINHAL with full text, and ProQuest Dissertations & Theses were mainly searched for full-text articles from inception till December 2018 to identify studies assessing the quality of life of living liver donors. The methodological quality of the included studies was examined. The quality of life post-donation at five assessment points, <= 1 month, 3 months, 6 months, 12 months, and >= 24 months were compared with the pre-donation, respectively. Results: The search yielded 2215 records, and a total of 15 articles (13 studies) with 715 donors were included in this meta-analysis. Physical functioning scores at <= 1 month, 3 months, 6 months, 12 months, and >= 24 months post-donation were significantly lower than pre-donation [overall standardized mean difference (SMD) = -0.67, 95% CI: -0.86, -0.49; p <=]. Significantly higher level of pain was found at 3-month post-donation (SMD, -1.05; 95% CI: -1.26, -0.85; p < 0.00 001). Also, a significantly higher level of anxiety was found at 3-month post-donation (SMD, -0.29; 95%CI: -0.51, -0.07; p = 0.01), but there were no significant changes in general psychological state and depression. A significant reduction in donors' social quality of life (SMD, -2.61; 95%CI: -4.75, 0.48; p = 0.02) was found at <= 1-month post-donation, and recovery to pre-donation levels occurred at 3 months post-donation. Conclusions: Living liver donation was associated with a decline in physical functioning, which was sustained for longer than 2 years post-donation. Impaired social and psychological quality of life affected donors for 1-3 months after their donation. The quality of life of living liver donors has become a pressing issue requiring more attention from doctors and nurses within the transplant team. However, multicenter, prospective, and longitudinal studies are needed to confirm the long-term safety of living liver donors. (C) 2020 Elsevier Ltd. All rights reserved.