The impact of living-related kidney transplantation on the donor's life.
BACKGROUND
Living-donation kidney transplantation (LDKT) is increasingly performed for treatment of chronic renal failure. Recently, risks for the donor and problems in decision-making have been stressed. This study was conducted to illuminate the decision making-process and consequences of LDKT on family life, the financial and occupational situation. Moreover, quality of life (QOL) and mental distress were explored.


METHODS
All German residents at Essen University, who donated their kidney between 1999 and 2003, were included in the study. Donors filled out the questionnaire of the European Multicenter Study of Transplantation Using Living Donors, the Short Form 36-Health Survey, and the Brief Symptom Inventory.


RESULTS
Out of a total of 65 donors, 47 replied (72%) at an average 2.5 years postdonation. No fatalities occurred in the whole sample (n=65), medical complications were experienced by 28%. Most donors decided voluntarily (94%) and spontaneously (66%) to donate, after donation 96% stated that they would decide in the same way again. QOL was within the norm. On the other hand, 10% experienced family conflicts, every eighth donor suffered from clinically relevant distress, financial disadvantages were experienced by every fourth donor, with 25% not answering this question.


CONCLUSIONS
Seen from the donor's perspective, LDKT is a relatively safe procedure. However, increased rates of donors with mental distress and intra-familial conflicts emphasize the need for a careful selection process. Regular postdonation psychosocial screening and provision of specific interventions to those in need are recommended. Donors should not suffer from financial and occupational disadvantages resulting from donation.
Reimer
Jens
J
Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, and Department of Nephrology, School of Medicine, University Hospital Essen, Essen, Germany. reimer@uke.uni-hamburg.de
Rensing
Anne
A
Haasen
Christian
C
Philipp
Thomas
T
Pietruck
Frank
F
Franke
Gabriele Helga
GH
D000328:Adult; D000368:Aged; D003657:Decision Making; D004522:Educational Status; D004651:Employment; D005190:Family; D005260:Female; D006498:Hepatectomy / Q000523:psychology*; D006801:Humans; D007668:Kidney; D016030:Kidney Transplantation; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009790:Occupations; D018579:Patient Selection; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D020858:Tissue and Organ Harvesting / Q000523:psychology*