The Experiences of Donor and Recipient within Living-Donor Liver Transplantation
Date Issued
2012
Date
2012
Author(s)
Lee, Yun-Jung
Abstract
Owing to the progress of medicine, liver transplantation has become the treatments of choice for end stage liver disease. However, live donor liver transplantation (LDLT) outnumbered cadaveric transplantation greatly at Taiwan due to the shortage of cadaveric donor. This study aimed to investigate the experience of donors and recipients throughout LDLT, the interactions between donors and recipients, and their adaptations for such experience.
In this retrospective study, a total of 23 interviewees, 12 donors and 11 recipients, were enrolled from a medical center at northern Taiwan between August 2011 to May 2012. The one-by-one in-depth interview was performed with purposive sampling and phenomenological point of view. The interviews can be divided into three parts: donor adaptation to the transplant experience, recipient adaptation to transplant experience, and the interactions between donor and recipient.
The time for donor interview ranged between 23 to 80 minutes (mean 53 min). The donor experience can be grouped into themes of uncertainty, suffering, and confirming of recovery. In the theme of “uncertainty”, they were informed of the bad condition of their family and the possible contraindications for liver donation. In the theme of “suffering”, they experienced physical pain of surgery and hoped everything passed quickly. In the third theme of “recovery”, they experienced periods of doubt of recovery, re-examine, more experience of life, and return to normal life. The adaptation to these experiences can be divided into themes of cognitive and overt act. The cognitive act included positive perception and compromised idea, and the overt act included facing the recovery process and restrictions after liver donation operation.
The time for recipient interview ranged from 25 to 85 minutes (mean 56 min), and can be divided into four different themes. In the first theme of “facing the threat of death”, they experienced the dark days of liver failure, and the shock when they were informed the need for liver transplant. In the second theme of “contraindication”, they experienced the questions of wish to live, where comes the donor, and the struggles between live donor and cadaveric donor liver transplantation. In the third theme of “recovery”, they experienced weakness after operation and feeling of recovery after transplant. In the forth theme of “restart”, they review the past days, check the present days, and look to the future days. As to the cognitive adaptation to these experiences, they had positive perception and compromised their idea. In the overt act, they faced the process of transplantation and accepted the restriction of life after the transplant.
This study also compared the interactive relationship between donor and recipient preoperatively and postoperatively, and demonstrated major differences of the change of interactive pattern and the increase of interaction frequency.
The results of this study can help patients to express their experiences, the clinical health providers to understand the real feelings of patients, and to promote mutual interactions between them to enhance the quality of care.
Subjects
liver transplantation
experience
adaptation
interaction
Type
thesis
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