Living liver donors suffer afterward

By Atsuko Kinoshita

The Yomiuri Shimbun

TOKYO - (KRT) - People who sacrifice part of their livers to save others often suffer health problems and a lack of psychological support when the recipients receive more attention.

A liver transplant from a living donor is carried out by removing a section of the healthy organ from the donor and transplanting it into a patient with a serious liver disorder.

More than 2,600 such liver transplants had been performed as of late 2003. The first living liver transplant in Japan took place 15 years ago.

One 34-year-old woman who donated part of her liver to save her mother said she was happy that she had been able to save her, but was still living with health concerns.

She said she was unable to sleep the night before the operation, which was performed two years ago at a university hospital in the Kanto region.

"I thought of running away, even if I was criticized for the rest of my life," she said.

She decided to donate her liver when she was told that a transplant was the only way to save her mother, who had cirrhosis of the liver. Since her mother had given both her and her sister life, even though she was small and frail, "I know that if I didn't donate, I would regret it for the rest of my life," she said.

Her mother initially rejected her offer, saying she would not hurt her daughter to save her own life. But the woman's husband was able to convince her to agree to the operation.

Later, though, when the woman thought of someone actually cutting open her body and removing part of her liver, she felt frightened. She was able to gain comfort by telling the doctor honestly of her fears.

After the operation, her mother wept and thanked her. The woman held her mother's hand and apologized in her heart for having contemplated running away.

Her mother recovered and is now well enough to travel. But the donor was left with a large scar on her abdomen and lingering health concerns. When she heard of the first death of a living donor in May last year, a shiver went down her spine.

The Japan Society for Transplantation regards such liver transplants as an extreme step since it can damage the health of the donor.

But the shortage of livers from brain-dead donors has led to the increase in the number of living transplants. Only 30 transplants using livers from brain-dead donors have been performed in Japan since the procedure was legalized in 1997.

Living donors suffer psychological and physical problems after transplants, according to a survey by the Japanese Liver Transplantation Society, the first of its kind organized by doctors specializing in transplants.

Of the living donors surveyed, 47 percent suffered health problems sleep disorders and pain and keloid formation around scars, while 39 percent were concerned about future health problems. Fifteen percent regretted donating their livers because of the pain, which was greater than they had expected, and 12 percent felt ignored when most of the attention was paid to recipients.

A total of 256 donors could not be traced by the hospitals that performed the transplants.

"Transplant therapy must also involve protecting the health of the donors. They must be given more thorough care by setting up sections specializing in donor care in hospitals," Tohoku University Prof. Susumu Satomi, who is a member of the society, said.

In addition, if the liver recipient dies, donors suffer even greater pain.

A 57-year-old women in the Kansai region lost her husband 20 days after donating part of her liver to him in 1999. The husband, then 57, had liver cancer.

Although she does not regret having donated her liver, she was angry when the hospital asked her to leave because they did not have enough beds.

She was experiencing pain and tension in her abdominal area, and bile seeped from the scar. In addition, she felt lost because she had not been able to save her husband.

"Donors are left with physical scars and immense psychological burdens," she said.

The woman who overcame her fear to donate her liver to her mother wrote on a Web site, "I learned many things about life, about appreciation and the importance of family."

But she also wrote of the fear she experienced and asked others not to blame those who found themselves unable to volunteer to donate, even though they were physically able.

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Copyright © 2004 The Yomiuri Shimbun.

This article posted November 22, 2004.