Study finds that ambivalence is common among liver donor candidates

Living donors are important to increasing the number of viable grafts for liver transplantation. A new study published in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, found that ambivalence is common among donor candidates. However, providing social support may help minimize the donors' concerns regarding donation.

There is much demand for organs and a shortage of deceased organ donations. One solution to this shortage is the use of living donors for liver transplantation. While previous research shows that adult living donor liver transplantation is on the rise in the U.S., comprising nearly 10% of liver transplants, the percentage of living donor liver transplantation is much higher than deceased organ transplants in Asian countries at 99% in Japan, 66% in Korea, and 37% in Taiwan.

"One challenge to increasing the number of living organ liver transplants is donor ambivalence," explains lead researchers Dr. Li-Chueh Weng with the School of Nursing, College of Medicine at Chang Gung University and Dr. Wei-Chen Lee with the Transplant Center at Chang Gung Memorial Hospital. "The donor wants to donate part of their liver to save the family member's life, but he or she is fearful or conflicted, which creates ambivalence toward the donation process."

Medical evidence suggests that among living organ donors the prevalence of ambivalence is between 5% and 15%, with the ambivalence being so severe that up to 15% of individuals are not able to become donors. Given the potential for adverse mental affects of living liver donors' ambivalence, the present study investigated the effect of social support and concerns related to the donation process.

For this cross-sectional study, the team recruited 100 living liver donor candidates who went through pre-transplant evaluation between April and October 2009 at a center in Taiwan. All participants completed a survey designed to measure ambivalence, donation concerns, and social support.

Results show that donors had a average ambivalence score of 3, with only 7% of the study population reporting no ambivalence during the assessment. Researchers found donor ambivalence was linked to physical, psychosocial and financial concerns, but social support mediated those concerns. "We recommend additional social support to minimize donation-related concerns and reduce ambivalence of living liver donors," concludes Dr. Weng.