Organ donors told of pitfalls
People who donate organs were warned yesterday to consider the emotional stress they might face in the aftermath of their altruistic acts after a woman, distressed after giving part of her liver to her aunt, recently tried to kill herself.
The woman was upset over a large scar the surgery left on her abdomen. Compounded with problems she had with her boyfriend, this drove her to slash her wrist, the head of the University of Hong Kong liver transplant team said.
Lo Chung-mau said it was the first time a liver donor had become suicidal after a transplant, and he cautioned potential donors about the psychological ramifications.
Professor Lo said taking organs from dead people was preferred.
'We never encourage living donations. It is only the very last resort to save lives,' he said. 'If there were more cadaveric liver donations in Hong Kong, fewer living donors would have to suffer psychologically and physically.'
The woman, who donated part of her liver to her aunt in 2007, developed emotional problems and attempted suicide the following year. She was saved and has since been receiving psychiatric treatment.
'During our follow-up sessions, this donor expressed emotional problems because of the surgical scar. She also had relationship problems with her boyfriend after the transplant and she is unhappy at work as well,' Professor Lo said.
He said a big inverted-Y-shaped scar that surgery leaves on a donor's abdomen, 20cm in radius, could easily create psychological pressure.
'It is not uncommon among liver donors that they are distressed by the scars, which will be with them for the rest of their life,' he said.
In another case, a woman needed counselling after she donated part of her liver to her husband, who died shortly after the operation.
'The wife kept blaming herself that she had failed to save her husband's life - she thought her liver was not good enough.'
Before a transplant, liver donors are counselled by doctors and a clinical psychologist. The transplant team also provides life-long annual check-ups for all donors.
Professor Lo said the team always used 'threat tactics' on potential donors to ensure they were 'determined and ready' to deal with the aftermath of the operation.
'We always emphasise to them that a living donation is the last resort and the operation is risky. Donors may lose their lives and have to go through some psychological problems because of the scar.
'We also tell them that they may lose their jobs, as their physical condition may not be good for a period. All donors have to be very clear about these risks and problems.'
The team uses even stronger warnings for donors who have a distant relationship with the recipients.
'To parents who want to save the lives of their children, we have no doubt about their determination,' Professor Lo said. 'But to distant relatives or even strangers who want to donate their livers, we are particularly cautious about their readiness. We would emphasise more the negative side of making a donation.'
Although organ donation from dead patients is expected to reach a record this year, doctors said there was still a big shortage.
There were 40 deceased kidney donors and 18 liver donors in the first quarter this year, compared with 65 and 29 in all of last year.
Hospital Authority figures show that more than 1,500 people are waiting for kidney transplants and 106 for livers. Nearly half of liver patients die while waiting for a transplant.
Nearly half of liver patients die waiting for a transplant
The number of people waiting for a liver transplant: 106