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Psychosocial evaluation of live donors

Purpose of reviewRecent studies highlight the need for a comprehensive psychosocial evaluation as part of the live donor liver transplantation workup. This review highlights recent empirical data regarding the psychosocial and quality of life outcomes associated with live liver donation and presents a comprehensive strategy for the psychosocial evaluation of donor candidates. Recent findingsExtending and improving the life of the recipient continue to be primary motivators for donors. Overt pressure or coercion is uncommon. The psychosocial evaluation is recognized as an integral part of the donor assessment, and a small percentage of candidates are rejected for psychosocial reasons. The majority of donors experience quality of life decrements in the first several months, although there is a return to predonation baseline by 1 year. There are few, if any, persistent mental health problems following donation, although factors that increase risk for psychosocial complications have not been delineated. SummaryPredonation psychosocial assessment is necessary to examine issues of informed consent, decision-making processes, coercion, the donor–recipient relationship, and psychological functioning. Similar evaluations should also be conducted during the first postdonation year. More research is needed to evaluate donor expectancies, psychosocial outcomes, and the role of behavioral health factors in donor outcomes.