Practice patterns for long-term follow-up of adult-to-adult right lobectomy donors at US transplantation centers

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Abstract
Protocols used by transplant centers to care for donors after right hepatectomy for living donor liver transplantation are not well described in the medical literature. Our goal is to describe practice patterns for the long-term follow-up of adult-to-adult right lobectomy donors at US transplantation centers. All adult liver transplantation centers listed with the United Network for Organ Sharing were surveyed between October and November 2002. A transplant coordinator, hepatologist, or surgeon from each center completed a 10-item telephone questionnaire. Of 97 adult liver transplantation centers, 90 centers (92.8%) completed the survey. Ninety-six percent of participants were transplant coordinators; 2%, hepatologists; and 2%, surgeons. One thousand forty-four right lobectomies have been performed by 51 (56.7%) transplant programs (range, 1 to 101 per center). Thirty-eight percent of active programs have performed fewer than 10 donation right lobectomies. Fifty-one percent of programs have a transplant coordinator who works specifically with donors. Thirty-five programs (68.3%) have a formal follow-up protocol, and an additional 13 centers (14.4%) reported their usual follow-up patterns. Protocols ranged from no formal follow-up to visits every few weeks in the early postoperative period followed by evaluation every 6 months. Evaluation beyond 12 months is typically on an as-needed basis. Personal psychosocial support services after donation were unusual and included regular phone calls from the coordinator (5 centers), quality-of-life instruments (3 centers), scheduled follow-up with the psychologist (1 center), or a satisfaction survey (1 center). Several centers provided newsletters, combined donor-recipient support groups, recognitions parties, and certificates. There is significant variability in the long-term care of donors. Formal psychosocial support after donation is rare.