title: Psychosocial impact of pediatric living-donor kidney and liver transplantation on recipients, donors, and the family: a systematic review.
abstract: Living-donor kidney and liver transplantation intend to improve pediatric recipients' psychosocial well-being, but psychosocial impact in recipients strongly depends upon the impact on the donor and the quality of family relations. We systematically reviewed quantitative and qualitative studies addressing the psychosocial impact of pediatric living-donor kidney and liver transplantation in recipients, donors, and the family. In accordance with the PRISMA guidelines, we systematically searched the databases Medline, Web of Knowledge, Cinahl, Embase, ERIC, and Google Scholar. We identified 23 studies that satisfied our inclusion criteria. Recipients had improved coping skills and satisfactory peer relationships, but also reported anxiety and depressive symptoms, worried about the future, and had a negative body image. Similarly, donors experienced increased self-esteem, empowerment, and community awareness, but also complained of postoperative pain and a lack of emotional support. With respect to family impact, transplantation generated a special bond between the donor and the recipient, characterized by gratitude and admiration, but also raised new expectations concerning the recipient's lifestyle. As psychological problems in recipients were sometimes induced by feelings of guilt and indebtedness toward the donor, we recommend more research on how gift exchange dynamics function within donor-recipient relationships, enrolling donors and recipients within the same study.
authors.affiliation: Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
authors.forename: Kristof
authors.initials: K
authors.lastname: Thys
authors.forename: Karl-Leo
authors.initials: KL
authors.lastname: Schwering
authors.forename: Marion
authors.initials: M
authors.lastname: Siebelink
authors.forename: Fabienne
authors.initials: F
authors.lastname: Dobbels
authors.forename: Pascal
authors.initials: P
authors.lastname: Borry
authors.forename: Paul
authors.initials: P
authors.lastname: Schotsmans
authors.forename: Isabelle
authors.initials: I
authors.lastname: Aujoulat
mesh_terms: D001294:Attitude to Health; D002648:Child; D005190:Family / Q000523:psychology*; D006498:Hepatectomy / Q000523:psychology; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology*; D016031:Liver Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D009392:Nephrectomy / Q000523:psychology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D066027:Transplant Recipients / Q000523:psychology*
keywords: family; kidney transplantation; liver transplantation; living-donor transplantation; psychosocial impact; systematic review