Is Cholecystectomy Really Harmful? A Long-Term Quality of Life Study in Living Donor Liver Transplantation
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Published on: August 17, 2022
Maria João Madeira-Cardoso1, Henrique Alexandrino2, Pedro Oliveira3
1Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Insights
Living donor liver transplantation (LDLT) and routine cholecystectomy do not negatively impact donor quality of life. Donors maintained high gastrointestinal quality of life and activity levels post-surgery.
Area of Science:
- Transplantation Surgery
- Hepatobiliary Surgery
- Quality of Life Research
Background:
- Living donor liver transplantation (LDLT) is a vital procedure for end-stage liver disease.
- Cholecystectomy is a standard part of LDLT donor surgery.
- Long-term effects of cholecystectomy on donor gastrointestinal (GI) quality of life (QoL) remain under-explored.
Purpose of the Study:
- To evaluate the impact of LDLT and cholecystectomy on donor QoL.
- To assess overall, abdominal wall-related, activity-level, and GI-related QoL in living liver donors (LLD).
Main Methods:
- Compared 21 LLD to 29 controls undergoing cholecystectomy for gallbladder polyps.
- Utilized SF-36, Gastrointestinal Quality of Life Index, EuraHS, and International Physical Activity Questionnaire.
- Stratified participants into younger (25-45 years) and older (46-65 years) age groups.
Main Results:
- LLD demonstrated global QoL comparable to controls and superior to the general Portuguese population.
- Younger LLD showed enhanced vitality and mental health.
- Abdominal wall impact was minimal, and activity levels were higher in younger LLD compared to controls.
- GI-related QoL was high, with fewer GI symptoms in older LLD than older controls.
Conclusions:
- LDLT and associated cholecystectomy do not adversely affect donor general QoL, abdominal wall status, or activity levels.
- Cholecystectomy does not appear to induce long-term GI symptoms in living liver donors.
Background:
Living donor liver transplantation (LDLT) is an accepted option for patients with end-stage liver disease. However, it potentially carries the risk of donor morbi-mortality, as well as long-term functional impairment. Cholecystectomy is performed routinely in the donor intervention, but the long-term effect on gastrointestinal (GI)-related quality of life (QoL) has never been explored previously. This study evaluated living donors' overall, abdominal wall-related, activity-level, and GI-related QoL.
Materials And Methods:
In total, 21 living liver donors (LLD) (57% women, mean age 45 ± 9 years) were compared to a control group (29 patients) undergoing cholecystectomy for gallbladder polyps (45% women, mean age of 46 ± 7 years). LLD and controls (Ctl) were divided into 2 age groups: LLD-Y and Ctl-Y (25-45 years); and LLD-O and Ctl-O (46-65 years). Generic SF-36, Gastrointestinal Quality of Life Index, EuraHS for abdominal wall status assessment, and International Physical Activity Questionnaire were performed. Standard age-adjusted Portuguese population SF-36 scores were used.
Results:
Global QoL results were better than Portuguese population scores and not inferior when compared to controls, scoring higher in the LLD-Y group in domains as vitality and mental health (P < .05). The abdominal wall impact was minimal among LLD. The activity level was significantly higher in LLD-Y than in Ctl-Y. Overall GI-related QoL was very close to the maximum score, and GI symptoms were significantly less in LLD-O compared with Ctl-O.
Conclusion:
LDLT had no impact on donors' general, abdominal wall-related QoL or activity level. The performance of cholecystectomy apparently had no impact on the development of GI-related symptoms.
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