1Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
Donor safety in living liver donation is of paramount importance, however, information on long-term outcomes is limited by incomplete follow-up. We sought to ascertain factors that predict post-donation follow-up in 456 living liver donors in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Completed donor follow-up was defined as physical, phone, or laboratory contact at a given time point. Univariate and multivariable mixed effects logistic regression models were developed to predict completed follow-up using donor and recipient demographic and clinical data and donor quality of life data. 90% of donors completed follow-up in the first three months, 83% at year 1; completed follow-up ranged from 57% to 72% in years 2-7 and from 41% to 56% in years 8-10. The probability of completed follow-up in the first year was higher for white donors (odds ratio (OR)=3.27, 95% confidence interval (CI)=1.25-8.58), but lower for donors whose recipients had hepatitis C virus or hepatocellular carcinoma (OR=0.34, 95% CI=0.17-0.69). After the first year, older age at donation predicted more complete follow-up. There were significant center differences at all time points (OR range 0.29-10.11), with center variability in both return for in-center visits and in the use of phone/long distance visits. Donor follow-up in the first year post-donation was excellent but decreased with time. Predictors of follow-up varied based on the time since donation. Adapting center best practices, enhanced by using telephone and social media to maintain contact with donors, represents a significant opportunity to gain valuable information about long-term donor outcomes.