Parental live liver donation: psychosocial considerations in the decision to donate

Live donor liver transplantation is a treatment option for patients in need of orthotopic liver transplantation to mitigate the organ shortage from deceased donors. The long-term outcomes for pediatric recipients from live liver donors are excellent, and parents commonly are the ones seeking donation to save their child from irreversible liver failure. Although live donors go through a careful medical and psychosocial evaluation to ensure the benefits of donation outweigh the risks, parental live liver donation poses unique challenges due to the biological and emotional relationships with the child. This article highlights specific psychosocial considerations for parental live liver donors.

There is limited research regarding the psychosocial evaluation and outcomes for live liver donors. Some literature suggests the need for standard criteria regarding the psychosocial evaluation of donors because of the risks. However, there are positive benefits with donation, such as improved emotional quality of life for adult to pediatric donors, and the possible benefits should be considered.

Live liver donation is an appealing alternative treatment option, particularly in the pediatric population, in which outcomes are generally positive and medical risk to donor is less than adult-to-adult donation. For parental donors, special consideration should be given to the informed consent and the decision-making process, psychological health, and presence of substance use when weighing the risk versus protective factors for donors.