Predictors of decision ambivalence and the differences between actual living liver donors and potential living liver donors

<div><p>Background</p><p>The decision to become a living liver donor is a stressful event. Ambivalence in decision making may result in psychological distress. Thus, the purpose of this study was to provide a description of the ambivalence of potential living liver donors, to examine the predictors of ambivalence, and to compare the ambivalence of potential living liver donors with that of actual living liver donors.</p><p>Methods</p><p>This descriptive and correlational study was conducted in a medical center from August 2013 to December 2015. Self-reported questionnaires were used to collect data. A total of 263 potential living liver donors who were assessed for donation to their parents were included in this study.</p><p>Results</p><p>The mean age of the total sample was 30.7 years (SD = 6.39, range = 20–47), and males comprised 53.6% of the sample. The majority of the potential donors had a college education (70.8%) and were single (63.5%). Of the total sample, the mean score for ambivalence was 4.27 (SD = 1.87, range = 0–7). Multivariate analysis revealed that the Mental Component Summary (MCS) of quality of life (<i>β</i> = -0.24, <i>p</i> < 0.01), family support (<i>β</i> = -0.17, <i>p</i> = 0.007), and intimacy (<i>β</i> = -0.13, <i>p</i> = 0.04) were significant protective predictors of ambivalence. Actual living liver donors had significantly lower ambivalence (3.82 versus 4.60), higher intimacy with recipients (3.55 versus 3.34), higher MCS (45.26 versus 42.80), and higher family support (34.39 versus 29.79) than did the remaining potential living liver donors.</p><p>Conclusion</p><p>Ambivalence is common in potential living liver donors. The MCS of quality of life, family support, and intimacy were protective predictors in terms of ambivalence. Future research should explore other factors and design interventions targeted toward reducing ambivalence, promoting family support, and enhancing the mental dimensions of quality of life in potential living liver donors.</p></div

Basic data of study sample (<i>N</i> = 263).

<p>Basic data of study sample (<i>N</i> = 263).</p

Demographic data of the study subjects.

<p>Abbreviations: MARS, Molecular adsorbent recycling system; MELD, Model for end-stage liver disease score.</p

Comparison of the degree of ambivalence among different characteristics (<i>N</i> = 263).

<p>Comparison of the degree of ambivalence among different characteristics (<i>N</i> = 263).</p

Pre-operative predictors of short-term morbidity and mortality rate.

<p>Abbreviations: ICU stay, intensive care unit stay.</p

Scores for ambivalence, intimacy, PCS, MCS, family support, and family conflict (<i>N</i> = 263).

<p>Scores for ambivalence, intimacy, PCS, MCS, family support, and family conflict (<i>N</i> = 263).</p

Predictors of ambivalence: Multiple linear regression analysis (<i>N</i> = 263).

<p>Predictors of ambivalence: Multiple linear regression analysis (<i>N</i> = 263).</p

Pre-operative clinical parameters of the patients who underwent liver transplantation (n = 147), by univariate analysis.

<p>Abbreviations: MARS, Molecular adsorbent recycling system; MELD, Model for end-stage liver disease score.</p

Pre-operative predictors of post-operative respiratory failure by multivariate analysis.

<p>Abbreviations: MARS, Molecular adsorbent recycling system; MELD, Model for end-stage liver disease score.</p

Association between postoperative survivals and expression levels of prognostic miRNAs.

<p>(A) Comparison of postoperative RFS between patients with higher and lower expression levels of miR-15a, miR-486-3p, miR-381, miR-30c, miR-155, miR-432, miR-15b and miR-30b, respectively. (B) Comparison of postoperative OS between patients with higher and lower expression levels of miR-29a, miR-486-3p and miR-876-5p. (C) Combination of six miRNA (miR-155, miR-15a, miR-432, miR-486-3p, miR-15b and miR-30b) markers as a prognostic score for RFS in HCC. ‘n’ represents the number of samples in each miRNA marker. The <i>P</i> value from the log rank test is shown in each panel.</p