Exploring the Mental Health of Living Kidney Donors

Abstract

Living donor kidney transplantation is the best option for extending and improving the lives of patients with end-stage renal disease. The benefits for the donor are less straightforward: a donor is a healthy person who undergoes a surgery in the first place for the benefit of another person. It is therefore of great importance to minimize negative medical and psychologi¬cal outcomes after living kidney donation and optimize positive outcomes. There is little research on the psychological outcomes after living kidney donation and how donors should be supported in order to prevent negative psychological outcomes. Therefore the aims of this thesis were to examine whether there is a change in mental health between predonation and postdonation among living kidney donors and to identify the socio-demographic, psychological, and medical factors that have an influence on (change in) living kidney donors’ mental health.

The main conclusion is that mental health remained the same for the majority of living kidney donors till one year after donation, while mental health im¬proved or deteriorated for a minority after donation. However, the changes among the minority of donors were not more or less than the changes found in mental health among the general population. This indicates that the changes among donors are not triggered by the donation process. Therefore, we did not find evidence to reject potential donors based on psychological reasons, except for donor candidates who are incompetent to give informed consent due to an impaired mental health status. In addition, we identified a number of donors who may benefit from additional psycho¬logical support during the donation process. It is recommended that professionals examine the risk profile prior and during the donation process and the need for additional psychological support in the case of one or more risk factors. Interventions could be focused on decreasing stress/psychological symptoms, increasing wellbeing, and/or the risk factors, such as an intervention on unrealistic expectations. These recommendations will strengthen the psychosocial support of living kidney donors.