title: The impact of the donors' and recipients' medical complications on living kidney donors' mental health.
abstract: A minority of living kidney donors (between 5-25%) have poor psychological outcomes after donation. There is mixed evidence on the influence of medical complications on these outcomes. We examined whether medical complications among donors and recipients predicted changes in donors' mental health (psychological symptoms and well-being) between predonation and 1 year postdonation. One-hundred and forty-five donors completed questionnaires on mental health predonation and 3 and 12 months postdonation. Number of recipient rehospitalizations and donor complications (none; minor; or severe) were obtained from medical records at 3 and 12 months after surgery. Multilevel regression analyses were used to examine the association between medical complications and changes in donors' mental health over time after controlling for sociodemographic characteristics. We found that donor complications (P = 0.003) and recipient rehospitalizations (P = 0.001) predicted an increase in donors' psychological symptoms over time. Recipient rehospitalizations also predicted a decrease in well-being (P = 0.005) over time; however, this relationship became weaker over time. We conclude that medical complications experienced by either the donor or recipient is a risk factor for deterioration in donors' mental health after living kidney donation. Professionals should monitor donors who experience medical complications and offer additional psychological support when needed.
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Lotte
authors.initials: L
authors.lastname: Timmerman
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Laging
authors.affiliation: Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Reinier
authors.initials: R
authors.lastname: Timman
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Willij C
authors.initials: WC
authors.lastname: Zuidema
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Denise K
authors.initials: DK
authors.lastname: Beck
authors.affiliation: Department of General Surgery, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jan N M
authors.initials: JN
authors.lastname: IJzermans
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Michiel G H
authors.initials: MG
authors.lastname: Betjes
authors.affiliation: Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jan J V
authors.initials: JJ
authors.lastname: Busschbach
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
authors.affiliation: Department of Internal Medicine, Section Nephrology and Transplantation, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Emma K
authors.initials: EK
authors.lastname: Massey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008603:Mental Health; D008875:Middle Aged; D009392:Nephrectomy / Q000523:psychology*; D011183:Postoperative Complications; D011788:Quality of Life; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000601:surgery*; D012307:Risk Factors; D012649:Self Concept; D011795:Surveys and Questionnaires; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D055815:Young Adult
keywords: living donors; nephrectomy; prospective studies; psychological adaptation; psychosocial aspects; well-being